Journals / Koşuyolu Heart Journal / 2018 / Cilt: 21 - Sayı: 3

Impact of Percutaneous Mitral Balloon Valvuloplasty on P-Wave Dispersion in Patients with Rheumatic Mitral Stenosis

Romatizmal Mitral Stenozlu Hastalarda Perkütan Mitral Balon Valvüloplastinin P Dalga Dispersiyonu Üzerine Etkisi

Pages
225–229
Publication Date
2018-12-02
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Further prospective long-term studies are needed to confirm the relationship between atrial conduction velocities and development of AF in patients with MS.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Introduction: P-wave dispersion (PWD) is a new electrocardiographic (ECG) index believed to reflect heterogeneous atrial conduction with ECG leads of different orientation.
📊
Key Findings & Data:Mitral stenosis (MS) is associated with increased PWD, which are markers of atrial fibrillation (AF) risk.
💡
Conclusion & Impact:Further prospective long-term studies are needed to confirm the relationship between atrial conduction velocities and development of AF in patients with MS.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Mitral stenoz · perkütan mitral balon valvüloplasti · p dalga dispersiyonu

Abstract

Introduction: P-wave dispersion (PWD) is a new electrocardiographic (ECG) index believed to reflect heterogeneous atrial conduction with ECG leads of different orientation. Mitral stenosis (MS) is associated with increased PWD, which are markers of atrial fibrillation (AF) risk. The aim of the present study was to assess the immediate effect of successful percutaneous mitral balloon valvuloplasty (PMBV) on these parameters. Patients and Methods: Seventy patients (98% females, aged 44 ± 12 years) with moderate or severe rheumatic MS and 60 healthy volunteers (95.7% females, aged 45 ± 11 years) as a control group were enrolled in the study. 12-Lead ECGs were recorded for each patient 1 day before PMBV to evaluate baseline maximum and minimum P-wave duration and PWD and repeated within 72 h. Results: The maximum P-wave duration (Pmax) and PWD in patients with MS were found to be significantly higher than those in the control group (p< 0.001). ECG parameters of Pmax (142 (120-170) vs. 130 (110-164), p< 0.001) and PWD [45 (30-69) vs. 35 (16-57), p< 0.001] decreased in the acute period of PMBV (p< 0.001). On the other hand, the procedure had no significant effect on minimum P-wave duration (p= 0.111). Conclusion: Our study has shown that Pmax and PWD were significantly higher in patients with MS than in healthy control subjects, and they decreased significantly after successful PMBV. Further prospective long-term studies are needed to confirm the relationship between atrial conduction velocities and development of AF in patients with MS.

Özet

Giriş: P dalga dispersiyonu (PDD), farklı elektrokardiyografi (EKG) leadlerinden heterojen atriyal iletiyi yansıttığına inanılan yeni bir elektrokardiyografik indekstir. Mitral stenoz (MS), atriyal fibrilasyon (AF)’un bir göstergesi olan artmış PDD ile ilişkilidir. Çalışmamız başarılı perkütan mitral balon valvüloplasti (PMBV)’nin bu parametreler üzerine olan etkisini incelemek için tasarlandı. Hastalar ve Yöntem: Orta ve ciddi romatizmal mitral stenozu olan 70 (%98 kadın, ortalama yaş 44 ± 12) hasta ve 60 (%95.7 kadın, ortalama yaş 45 ± 11) sağlıklı kontrol grubu çalışmaya alındı. PMBV’den 1 gün önce ve yapıldıktan sonra 72 saat içinde 12 derivasyonlu EKG çekilerek maksimum ve minimum P dalga süresi, PDD hesaplandı. Bulgular: Maksimum P dalga süresi ve PDD MS hastalarında kontrol grubuna göre anlamlı olarak fazla bulundu (p< 0.001). Pmax [142 (120-170) vs. 130 (110-164), p< 0.001] ve PDD [45 (30-69) vs. 35 (16-57), p< 0.00], PMBV sonrası akut dönemde azaldı (p< 0.001). Diğer yandan işlemin minimum P dalga süresi üzerine anlamlı etkisi olmadı (p= 0.111). Sonuç: Çalışmamızda MS’li hastalarda Pmax ve PDD’nin sağlıklı kontrol grubuna göre anlamlı olarak fazla olduğunu ve başarılı PMBV sonrası anlamlı derecede azaldığını gösterdik. MS’li hastalarda AF ile atriyal ileti velositeleri arasındaki ilişkiyi doğrulamak için prospektif uzun dönem takipli çalışmalara ihtiyaç vardır.

🔖

Cite This Article

AĞUŞ, H. Z., KAHRAMAN, S. (2018). Impact of Percutaneous Mitral Balloon Valvuloplasty on P-Wave Dispersion in Patients with Rheumatic Mitral Stenosis. Koşuyolu Heart Journal, Cilt: 21 - Sayı: 3, 225–229. https://ajindex.com/articles/63877

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (12)

  1. Otto CM, Bonow RO. Valvular heart disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, Braunwald E (eds). In: Braunwald’s Heart Disease: A Text Book of Cardiovascular Medicine 8th ed. Philadelphia: Saunders Elsevier, 2008:1646-57
  2. Josephson ME, Kastor JA, Morganroth J. Electrocardiographic left atrial enlargement. Electrophysiologic, echocardiographic and hemodynamic correlates. Am J Cardiol 1977;39:967-71
  3. Dilaveris PE, Gialafos EJ, Sideris SK, Theopistou AM, Andrikopoulos GK, Kyriakidis M, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998;135:733-8
  4. Turhan H, Yetkin E, Senen K, Yilmaz MB, Ileri M, Atak R, et al. Effects of percutaneous mitral balloon valvuloplasty on P-wave dispersion in patients with mitral stenosis. Am J Cardiol 2002;89:607-9
  5. Erbay AR, Turhan H, Yasar A, Bicer A, Senen K, Sasmaz H, et al. Effects of long term beta blocker therapy on P wave duration and dispersion in patients with rheumatic mitral stenosis. Int J Cardiol 2005;22:102:33-7
  6. Wilkins GT, Weyman AE, Abascal WM, Block PC, Palacios IF. Percutaneous mitral balloon valvulotomy: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J 1988;60:299-308
  7. Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two- Dimensional Echocardiograms. J Am Soc Echocardiography 1989;2:358-67
  8. Hatle L, Angelsen B, Tromsdal A. Noninvasive assessment of atrioventricular pressure half-time by Doppler ultrasound. Circulation 1979;60:1096-104
  9. Inoue K, Owaki T, Nakamura T, Kitamura F, Miyamoto N. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg 1984;87:394-402
  10. Alpert JS, Sabik J, Casgrove DM. Mitral valve disease. In: Topol EJ (ed). Textbook of cardiovascular medicine. New York: Lippincott-Raven Publishers, 1998;505-6
  11. Dilaveris PE, Gialafos EJ, Andrikopoulos GK, Richter DJ, Papanikolaou V, Poralis K, et al. Clinical and electrocardiographic predictors of recurrent atrial fibrillation. Pacing Clin Electrophysiol 2000;23:352-8
  12. Buxton AE, Waxman HL, Marchlinski FE, Josephson ME. Atrial conduction: effects of extrastimuli with and without atrial dysrhythmias. Am J Cardiol 1984;5