Determinants of left intra‐atrial electromechanical delay as evaluated by tissue Doppler imaging in candidates for coronary artery bypass graft surgery

Abstract

Objectives Inhomogeneity in the atrial conduction time is a predisposing factor for atrial fibrillation. The aim of our study was to determine the independent determinants of the left intra‐atrial electromechanical delay (LIAEMD) as a marker of left atrial (LA) dyssynchrony in candidates for coronary artery bypass graft surgery (CABGS). Methods This prospective cross‐sectional study recruited 516 consecutive candidates for CABGS. Via the pulsed‐wave tissue Doppler imaging modality in echocardiography, the times between the P wave and the peak of the a′ wave at the septal and lateral mitral annuli were measured and the difference between these times was considered to be LIAEMD. Additionally, clinical and laboratory data on each patient were gathered. The odds ratio for an increased LIAEMD was calculated in patients with and without diabetes in univariate and multivariate analyses. Results The multivariable analysis revealed that in the patients without diabetes, obesity, calcium‐channel blocker usage, an increased maximal LA volume, and a decreased lateral e′/a′ ratio and in the diabetic patients, diuretic usage and a decreased lateral e′/a′ ratio were independently correlated with an increased likelihood of LIAEMD occurrence (P < .05). Conclusions In our study on CABGS candidates, in the patients without diabetes, obesity, an increased maximal LA volume, calcium‐channel blocker usage, and a decreased lateral e′/a′ ratio and in the diabetic patients, diuretic usage and a decreased lateral e′/a′ ratio independently determined increased LIAEMD. The prevention or treatment of factors that are detrimental to the LA electromechanical function may be helpful for the preservation of the LA electromechanical integrity.

Determinants of the Volumetric Markers of Left Atrial Contraction Function in Coronary Artery Disease: A Cross-sectional Study

“…We previously presented the characteristics of the study population and the method of echocardiography in detail. 23) Briefly, our cross-sectional study recruited 516 patients in sinus rhythm who were candidates for isolated CABG. The study population was without a history of AF, cancer, previous cardiac surgery, cardiomyopathies, pericardial disease, significant valvular disease, thyroid disease, liver disease, end-stage renal disease, and inflammatory disease.…”

“…We previously defined the independent determinants of left intra-atrial electromechanical delay as a marker of pump synchronicity in patients who were candidates for CABG. 23) In the present study, we sought to determine the independent determinants of LA contraction function in the same sample by reanalyzing the same data.…”