Arterial Stiffness is Associated with Tissue Doppler Atrial Conduction Times and P Wave Dispersion in Hypertensive Patients

Abstract

Background Arterial stiffness is strongly predictive for cardiovascular events in hypertensive individuals and it may increase the risk of stroke. This study was designed to evaluate the possible relationship between arterial stiffness and atrial electromechanical delay and P wave dispersion (PWD), as determinants of AF risk. Materials and MethodsThe study included 75 hypertensive patients and 45 healthy control subjects. Atrial electromechanical coupling (time interval from the onset of P wave on ECG to the beginning of A wave with tissue Doppler echocardiography [PA]), intraatrial and interatrial electromechanical delay (EMD) and PWD were measured. Stiffness index β & PWV was measured to assess the arterial stiffness. Results The interatrial EMD and PWD were prolonged in hypertensive patients compared to controls (p< 0.01 for both), There was increased arterial stiffness (PWV and stiffness index β) in hypertensive patients compared to controls (6.43 ± 1.73 vs. 4.8 ± 1.6 m/sec & 4.9 ± 2.8 vs. 2.63 ± 1.2, p<0.01 for both). By multivariate analysis; PWV and Stiffness index β were independently correlated with interatrial EMD (B ± SE= 0.42 ± 1.87, B ± SE=0.39 ± 0.21 p<0.01 for both) and PWD (B ± SE=0.37 ± 1.93, p<0.01, B ± SE=0.25 ± 0.18, p<0.05 respectively). Conclusion In hypertensive patients arterial stiffness indexes increased and showed a significant correlation with interatrial EMD and PWD independent of other variables. Further research is needed to determine whether interventions that reduce arterial stiffness will limit the growing incidence of AF.

Evaluation of Correlation between Aortic Elastic Parameters and Atrial Electromechanical Abnormalities in Hypertensive Patients

“…They suggested that LV diastolic dyssynchronous changes might be caused by increased LV mass and arterial stiffness. Elsherbiny demonstrated that arterial stiffness indexes increased and showed a significant correlation with inter AEMD and P‐wave dispersion in hypertensive patients . In this study, we found increased intra‐left AEMD in hypertensive patients.…”

Evaluation of Atrial Electromechanical Coupling Times in Hemodialysis Patients

“…10,28 These findings support that atrial EMCTs are predominantly driven by left atrial EMCT. 10,28 These findings support that atrial EMCTs are predominantly driven by left atrial EMCT.…”

“…On the other hand, the left atrial diameter was correlated with maximum, interatrial and left atrial EMCTs. 10,28 In this study, there is no correlation found between BP and any of the atrial EMCTs. When indexed left atrium values were used, correlations were also significant and more pronounced between left atrium and maximum EMCT, interatrial EMCT, and left atrial EMCT.…”

“…19 Some studies show that, while maximum and PA-septal EMCT are significantly prolonged in parallel with BP in hypertensive patients, no difference was found in tricuspid atrial EMCT. 10,28 In this study, there is no correlation found between BP and any of the atrial EMCTs. This finding also supports that EMCTs prolong independently from BP in ESRF patients.…”

Left atrial morphology and function: A strong cardiovascular predictor of outcome

“…[4] LA stiffness derived from the ratio between LA reservoir and E/e’ is a noninvasive dimensionless parameter that was demonstrated to be correlated with invasive LA pressure. [5]…”