Prolonged atrial electromechanical delay and P-wave parameters in asymptomatic carotid artery stenosis: novel insights from a non-invasive evaluation

Faruk Serhatlıoğlu; Şaban Keleşoğlu

Article Details

Prolonged atrial electromechanical delay and P-wave parameters in asymptomatic carotid artery stenosis: novel insights from a non-invasive evaluation

Authors:

Faruk Serhatlıoğlu | Şaban Keleşoğlu

Publisher:

MediHealth Academy Yayıncılık

Main Topics:

Kardiyoloji

Journal:

Journal of Medicine and Palliative Care Vol.6 Issue 1, pp.20-26

Document Type:

Article

Publication Date:

2/2025

Document Language:

English

Document ID (Org No.):

2001341142

pISSN:

2717-7505

Keywords:

Abstract:

 Aims: Stroke is one of the top three causes of death in developed societies. Ischemic strokes are linked to carotid artery stenosis CAS. Atrial fibrillation AF is a commonly encountered clinical arrhythmia. It has been shown that the prolongation of intra- and interatrial conduction times, known as atrial electromechanical delay EMD, is associated with a higher risk of AF. We aimed to determine the correlation of atrial conduction abnormalities between surface electrocardiographic and TDI measurements in the CAS patient group. Methods: The study included 76 patients diagnosed with extracranial internal carotid artery ICA stenosis. Asymptomatic severe CAS was defined as patients with 70-99 stenosis detected by carotid digital subtraction angiography DSA. The longest P-wave and the longest atrial conduction time ACT were considered as the maximal P-wave duration. The difference between the longest P-wave Pmax and the shortest P-wave Pmin was accepted as PD. PDPmax-Pmin. Atrial EMD was defined as the time interval from the onset of atrial electrical activity to the beginning of mechanical atrial contraction. Results: The CAS group had significantly longer Pmax and PD values compared to the control group Pmax 104.726.03 and 93.067.26 ms, p0.001; PD 48.556.72 and 38.508.12 ms, p0.001. In the TDI examination, the atrial EMD parameters PA lateral, PA septum were significantly longer in the CAS group compared to the control group. 77.885.13 vs 65.539.11 ms; p0.0001; 63.773.95 vs 54.567.13 ms; p0.001 respectively Both interatrial and intra-atrial EMD times were found to be longer in the CAS group compared to the control group 31.727.39 vs 22.138.67 ms; p0.001; 17.617.76 vs 11.167.76 vs 11.167.04 ms; p0.001, respectively. In the correlation analysis, a positive relationship was found between interatrial and interatrial EMD and Pmax and PD p0.001, both. Conclusion: We found that both intra-atrial and inter-atrial electromechanical conduction times were longer in CAS patients. This suggests that CAS patients are at risk for AF in their follow-up.

 Aims: Stroke is one of the top three causes of death in developed societies. Ischemic strokes are linked to carotid artery stenosis CAS. Atrial fibrillation AF is a commonly encountered clinical arrhythmia. It has been shown that the prolongation of intra- and interatrial conduction times, known as atrial electromechanical delay EMD, is associated with a higher risk of AF. We aimed to determine the correlation of atrial conduction abnormalities between surface electrocardiographic and TDI measurements in the CAS patient group. Methods: The study included 76 patients diagnosed with extracranial internal carotid artery ICA stenosis. Asymptomatic severe CAS was defined as patients with 70-99 stenosis detected by carotid digital subtraction angiography DSA. The longest P-wave and the longest atrial conduction time ACT were considered as the maximal P-wave duration. The difference between the longest P-wave Pmax and the shortest P-wave Pmin was accepted as PD. PDPmax-Pmin. Atrial EMD was defined as the time interval from the onset of atrial electrical activity to the beginning of mechanical atrial contraction. Results: The CAS group had significantly longer Pmax and PD values compared to the control group Pmax 104.726.03 and 93.067.26 ms, p0.001; PD 48.556.72 and 38.508.12 ms, p0.001. In the TDI examination, the atrial EMD parameters PA lateral, PA septum were significantly longer in the CAS group compared to the control group. 77.885.13 vs 65.539.11 ms; p0.0001; 63.773.95 vs 54.567.13 ms; p0.001 respectively Both interatrial and intra-atrial EMD times were found to be longer in the CAS group compared to the control group 31.727.39 vs 22.138.67 ms; p0.001; 17.617.76 vs 11.167.76 vs 11.167.04 ms; p0.001, respectively. In the correlation analysis, a positive relationship was found between interatrial and interatrial EMD and Pmax and PD p0.001, both. Conclusion: We found that both intra-atrial and inter-atrial electromechanical conduction times were longer in CAS patients. This suggests that CAS patients are at risk for AF in their follow-up.

 Aims: Stroke is one of the top three causes of death in developed societies. Ischemic strokes are linked to carotid artery stenosis CAS. Atrial fibrillation AF is a commonly encountered clinical arrhythmia. It has been shown that the prolongation of intra- and interatrial conduction times, known as atrial electromechanical delay EMD, is associated with a higher risk of AF. We aimed to determine the correlation of atrial conduction abnormalities between surface electrocardiographic and TDI measurements in the CAS patient group. Methods: The study included 76 patients diagnosed with extracranial internal carotid artery ICA stenosis. Asymptomatic severe CAS was defined as patients with 70-99 stenosis detected by carotid digital subtraction angiography DSA. The longest P-wave and the longest atrial conduction time ACT were considered as the maximal P-wave duration. The difference between the longest P-wave Pmax and the shortest P-wave Pmin was accepted as PD. PDPmax-Pmin. Atrial EMD was defined as the time interval from the onset of atrial electrical activity to the beginning of mechanical atrial contraction. Results: The CAS group had significantly longer Pmax and PD values compared to the control group Pmax 104.726.03 and 93.067.26 ms, p0.001; PD 48.556.72 and 38.508.12 ms, p0.001. In the TDI examination, the atrial EMD parameters PA lateral, PA septum were significantly longer in the CAS group compared to the control group. 77.885.13 vs 65.539.11 ms; p0.0001; 63.773.95 vs 54.567.13 ms; p0.001 respectively Both interatrial and intra-atrial EMD times were found to be longer in the CAS group compared to the control group 31.727.39 vs 22.138.67 ms; p0.001; 17.617.76 vs 11.167.76 vs 11.167.04 ms; p0.001, respectively. In the correlation analysis, a positive relationship was found between interatrial and interatrial EMD and Pmax and PD p0.001, both. Conclusion: We found that both intra-atrial and inter-atrial electromechanical conduction times were longer in CAS patients. This suggests that CAS patients are at risk for AF in their follow-up.

 Arka Plan: İnme, gelişmiş toplumlarda ölümün ilk üç nedeninden biridir. İskemik inmeler karotis arter stenozu KAS ile bağlantılıdır. Atriyal fibrilasyon AF, yaygın olarak karşılaşılan bir klinik aritmidir. Atriyal elektromekanik gecikme EMD olarak bilinen intratriyal ve interatriyal iletim sürelerinin uzamasının daha yüksek AF riski ile ilişkili olduğu gösterilmiştir. KAS hasta grubunda yüzey elektrokardiyografi ve doku Doppler ekokardiyografi görüntülemeTDI ölçümleri arasındaki atriyal iletim anormalliklerinin korelasyonunu belirlemeyi amaçladık. Yöntemler: Çalışmaya ekstrakraniyal internal karotis arter IKA stenozu tanısı almış 76 hasta dahil edildi. Asemptomatik ciddi KAS, karotis dijital subtraction anjiyografisi DSA ile 60-99 stenoz tespit edilen hastalar olarak tanımlandı. En uzun P dalgası ve en uzun atriyal iletim süresi ACT, maksimum P dalgası süresi olarak kabul edildi. En uzun P dalgası Pmax ile en kısa P dalgası Pmin arasındaki fark PD olarak kabul edildi. PDPmax-Pmin. Atriyal EMD, atriyal elektriksel aktivitenin başlangıcından mekanik atriyal kasılmanın başlangıcına kadar geçen zaman aralığı olarak tanımlandı. Sonuçlar: KAS grubunda Pmax ve PD değerleri kontrol grubuna kıyasla anlamlı derecede daha uzundu Pmax 104,726,03 ve 93,067,26 ms, p0,001; PD 48,556,72 ve 38,508,12 ms, p0,001. TDI incelemesinde atriyal EMD parametreleri PA lateral, PA septum KAS grubunda kontrol grubuna kıyasla anlamlı derecede daha uzundu. 77,88 5,13 vs 65,53 9,11 ms; P 0,0001; 63,77 3,95 vs 54,56  7,13 ms; P 0,0001 sırasıyla Hem interatriyal hem de intra-atriyal EMD sürelerinin CAS grubunda kontrol grubuna göre daha uzun olduğu bulundu 31,72  7,39 vs 22,13  8,67 ms; P 0,0001; 17,61  7,76 vs 11,16  7,76 vs 11,16  7,04 ms; p 0,001, sırasıyla. Korelasyon analizinde, interatriyal ve interatriyal EMD ile Pmax ve PD arasında pozitif bir ilişki bulundu. p0,001, her ikisi de Sonuç: KAS hastalarında hem intraatriyal hem de interatriyal elektromekanik iletim sürelerinin daha uzun olduğunu bulduk. Bu, KAS hastalarının takiplerinde AF riski altında olduğunu düşündürmektedir.

Article Details

Prolonged atrial electromechanical delay and P-wave parameters in asymptomatic carotid artery stenosis: novel insights from a non-invasive evaluation

Authors:

Faruk Serhatlıoğlu | Şaban Keleşoğlu

Publisher:

MediHealth Academy Yayıncılık

Main Topics:

Kardiyoloji

Journal:

Journal of Medicine and Palliative Care Vol.6 Issue 1, pp.20-26

Document Type:

Article

Publication Date:

2/2025

Document Language:

English

Document ID (Org No.):

2001341142

pISSN:

2717-7505

Carotid artery stenosis

atrial fibrillation

atrial conduction timeKarotid arter stenozu

atriyal fibrilasyon

atriyal iletim süresi

Issues

Article Details

Prolonged atrial electromechanical delay and P-wave parameters in asymptomatic carotid artery stenosis: novel insights from a non-invasive evaluation

Authors: Faruk Serhatlıoğlu | Şaban Keleşoğlu

Publisher: MediHealth Academy Yayıncılık

Main Topics: Kardiyoloji

Journal: Journal of Medicine and Palliative Care Vol.6 Issue 1, pp.20-26

Document Type: Article

Publication Date: 2/2025

Document Language: English

Document ID (Org No.): 2001341142

pISSN: 2717-7505

Carotid artery stenosis

atrial fibrillation

atrial conduction timeKarotid arter stenozu

atriyal fibrilasyon

atriyal iletim süresi

Issues

Authors:

Faruk Serhatlıoğlu | Şaban Keleşoğlu

Publisher:

MediHealth Academy Yayıncılık

Main Topics:

Kardiyoloji

Journal:

Journal of Medicine and Palliative Care Vol.6 Issue 1, pp.20-26

Document Type:

Article

Publication Date:

2/2025

Document Language:

English

Document ID (Org No.):

2001341142

pISSN:

2717-7505