Effects of percutaneous mitral balloon valvuloplasty on P-wave dispersion in patients with mitral stenosis

Turhan, Hasan; Yetkın, Ertan; Şenen, Kubilay; Yilmaz, Mehmet Birhan; İleri, Mehmet; Atak, Ramazan; Çehreli, Şengül; Kütük, Emine

doi:10.1016/s0002-9149(01)02307-4

Cited by 44 publications

(53 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings are in agreement with Turhan et al 31 who demonstrated decrease in P-max and PWD, which were regarded as ECG signs of the susceptibility to AF in both the short and long terms after PBMV.…”

Section: Who Stated That Interatrial Emd Gets Longer In Mssupporting

confidence: 93%

Assessment of interatrial dyssynchrony by Tissue Doppler Imaging in mitral stenosis: Effect of afterload reduction after balloon mitral valvuloplasty

Saad

El-Salam

Elzaki

et al. 2016

The Egyptian Heart Journal

View full text Add to dashboard Cite

Background: The predisposition to atrial fibrillation (AF) in mitral stenosis (MS) has been demonstrated with several electrocardiographic (increased P-wave dispersion) and echocardiographic parameters (atrial electromechanical delay). After percutaneous mitral balloon valvuloplasty (PMBV), the improvement in echocardiographic parameters related to AF risk is unknown. We aimed to assess the interatrial electromechanical coupling by Tissue Doppler Imaging (TDI) echocardiography in MS before and after PBMV. Patients and methods: This study included 45 patients with moderate to severe MS who underwent successful PMBV without complication at our clinic and 20 healthy volunteers as a control group. We compared the two groups in regard to clinical, electrocardiographic and echocardiographic features. The patients with MS were also evaluated one week after PMBV. Interatrial electromechanical delay (EMD) was measured by TDI before and after PMBV and we compared the results.Abbreviations: A 0 wave, peak late annular velocity by TDI; AF, atrial fibrillation; BSA, body surface area; LA, left atrium; LAA, left atrial area; LAD, left atrial dimension; LAEF, left atrial ejection fraction; LAEI, left atrial expansion index; LAV, left atrial volume; MS, mitral stenosis; MV, mitral valve; MVA, mitral valve area; P-A 0 , the time interval from the initiation of the P wave on the ECG until the beginning of the late diastolic TDI signal at the lateral border of the annulus; PBMV, percutaneous balloon mitral valvuloplasty; P-max, maximum P-wave duration; P-min, minimum P-wave duration; PWD, P-wave dispersion; SPAP, systolic pulmonary artery pressure; TDI, Tissue Doppler Imaging Results: The interatrial EMD (56.4 ± 15.8 vs. 34.6 ± 7.2 ms, p < 0.001) was higher in patients with MS as compared to healthy individuals. The maximum P-wave duration (P-max) and Pwave dispersion (PWD) showed significant positive correlation with the interatrial EMD (r = 0.37, p < 0.05 and r = 0.41, p < 0.05 respectively). There was a highly significant decrease in the interatrial EMD (56.4 ± 15.8 vs. 38.3 ± 10.4 ms, p < 0.001) one week after PBMV. Conclusion: The current study showed significant increase in the interatrial EMD in patients with moderate to severe MS. These changes improved significantly after PMBV.ª 2015 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Cardiology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

show abstract

Section: Who Stated That Interatrial Emd Gets Longer In Mssupporting

confidence: 93%

Assessment of interatrial dyssynchrony by Tissue Doppler Imaging in mitral stenosis: Effect of afterload reduction after balloon mitral valvuloplasty

Saad

El-Salam

Elzaki

et al. 2016

The Egyptian Heart Journal

View full text Add to dashboard Cite

show abstract

“…They have also shown the AF predictors such as larger LA, age and smaller MVA (28) . Turhan et al demonstrated the decrease in maximum P-wave duration and PWD on the first day and at the end of the first month after PMBV (29) . However, they could not demonstrated that the decrease in maximum P-wave duration and PWD have no relation with improvement in MVA, LA size, LA pressure, PAPs and mean mitral gradient after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

Güler¹

2017

Kosuyolu Heart Journal

View full text Add to dashboard Cite

Introduction: AF in patients with mitral stenosis (MS) causes significant morbidity and mortality. PMBV, which is a treatment of choice for patients with MS, is a highly successful procedure that provides significant improvement in symptoms and echocardiographic parameters. In this study we aimed to demonstrate the probable effects of PMBV on novel echocardiographic and electrocardiographic parameters that can predict the development of AF in 1-year period in patients with MS. Patients and Methods:Twenty-eight patients with moderate or severe rheumatic MS (mean age 37.6 ± 7.4 years; 14 (50%) males) were enrolled this study. All patients who were eligible for this procedure underwent comprehensive echocardiographic examinations with evaluation of ACT measured using tissue Doppler imaging (TDI) before PMBW and repeated at the end of the 1 year after successful PMBV. In addition, 12-lead ECGs were recorded for each patient 1 day before PMBV for the evaluation of baseline maximum and minimum P-wave duration and P-wave dispersion (PWD); this was repeated at the end of the 1 year after successful PMBV.Results: ACT (148.1 ± 20.5 vs 121.3 ± 20.5 p< 0.001), P-max (151.7 ± 15.8 vs 137.3 ± 15.6 p< 0.001) and PWD (84.7 ± 18.8 vs 71.1 ± 18.5 p< 0.001) were found to be significantly decreased after PMBV. A strong positive correlation was detected between ACT, P-max, PWD, LAVi ve PAPs before and after PMBV. In addition, there was a strong correlation between Δ values that were measured by subtracting the baseline measurements from the post-PMBV measurements. Accordingly, ΔACT was correlated with ΔP-max ve ΔPWD (r= 0.5 p= 0.007 and r= 0.55 p= 0.002, respectively). ΔACT, ΔP-max and ΔPWD correlated significantly with only ΔLAVi and ΔPAP in echocardiographic parameters. Conclusion:This study demonstrated that atrial conduction properties that have also been evaluated with ECG and TDI studies significantly correlate with other echocardiographic parameters in patients with MS. In addition, significant improvement occurred in these parameters at the end of the 1 year after PMBV. Further prospective investigations may provide useful data for the detection of the relation between atrial electromechanical characteristics and development of AF in patients with MS.Key Words: Rheumatic mitral stenosis; atrial fibrillation; atrial conduction tine P-wave dispersion; percutaneous mitral balloon valvuloplasty Mitral Darlığı Olan Hastalarda Atriyal Elektiriksel ve Elektromekanik Özellikler ÖZETGiriş: Mitral darlığı olan hastalarda atriyal fibrilasyon (AF) önemli bir mortalite ve morbidite nedenidir ve bu hastalarda perkütan mitral balon valvüloplasti (PMBV) semptomlarda ve ekokardiyografik parametrelerde önemli düzelme sağlayan başarılı bir girişimdir. Bu çalışmada mitral darlıklı hastalarda PMBV'nin AF gelişimini predikte edebilen yeni ekokardiyografik ve elektrokardiyografik parametreler üzerindeki bir yıllık dönemdeki etkisinin gösterilmesi amaçlanmıştır. Hastalar ve Yöntem:Orta ve ileri mitral darlığı olan 28 hasta (ortalama yaş 37....

show abstract

“…Accordingly, many investigators have searched the PD in many cardiac diseases to determine whether it is useful or not to predict the risk of AF. Based on the available data obtained from these investigations, PD may be considered as a noninvasive electrocardiographic marker to predict the risk of AF, especially in some cardiovascular disorders as cardiomyopathy, rheumatic mitral stenosis, ischemic heart disease, hypertension, and paroxysmal AF which characterized with a high prevalence of AF (7,8,(25)(26)(27)(28)(29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

The effect of nebivolol on P wave duration and dispersion in patients with Behçet’s disease; a prospective single-arm controlled study

Akkaya¹,

Karakaş²,

Şahin³

et al. 2013

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Objective: Behçet's disease (BD) is a chronic multi-system disease presenting with recurrent oral and genital ulceration, and relapsing uveitis. Left ventricular diastolic dysfunction, ventricular arrhythmia and sudden cardiac death have been documented in BD. P wave dispersion (PD) has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. PD has been reported to be longer in patients with BD. Nebivolol, besides its selective beta1-blocking activity, causes an endothelium dependent vasodilatation through nitric oxide release. In this study, we searched for the effects of nebivolol on P wave duration and dispersion in patients with BD. Methods: This study was designed as prospective single-arm controlled study. We prospectively studied 35 Behçet's patients who were diagnosed according to the International Study Group criteria. Patients received 5 mg nebivolol per day for 3 months. The patients were evaluated with 12-leads electrocardiography at baseline and after for 3-month therapy. The difference between maximum and minimum P wave durations was defined as PD. The paired samples t test, Wilcoxon test were used for statistical analysis. Results: A significant decrease was observed in PD after therapy period (62.85±21.62 vs. 44.28±18.03 msec, p=0.001). No adverse effects were observed in treatment period. Conclusion: BD is associated with prolonged P wave duration and dispersion. We have shown for the first time that nebivolol causes a significant decrease in maximum P wave duration and PD in patients with BD. However, further comprehensive studies are needed to determine the long-term effects of nebivolol. (Anadolu Kardiyol Derg 2013; 13: 682-7) Key words: Behçet's disease, nebivolol, P wave dispersion Original Investigation Özgün Araşt›rma 682ÖZET Amaç: Behçet hastalığı (BH), tekrarlayıcı oral ve genital ülserasyon ve üveit atakları ile karakterize, kronik multisistemik bir hastalıktır. BH'da sol ventrikül diyastolik disfonksiyonu, ventriküler aritmi ve ani kardiyak ölüm vakaları bildirilmiştir. P dalga dispersiyonu (PD)'nun, sinüs uyarılarının homojen olmayan ve kesintili yayılımı ile ilişkili olduğu gösterilmiştir. PD'nin BH'da daha uzun olduğu gösterilmiştir. Selektif beta 1 bloker olan nebivolol, nitrik oksit salınımı sayesinde endotel bağımlı vazodilatasyon yapar. Bu çalışmada, BH'da nebivololün P dalga süresi ve PD üzerinde-ki etkisini araştırdık. Yöntemler: Bu araştırma prospektif, tek grup kontrollü çalışma olarak tasarlandı. Çalışmaya Uluslararası Çalışma Grubu kriterlerine uyan 35 BH alındı. Hastalara 3 ay süreyle 5 mg/gün nebivolol verildi. Hastalar başlangıçta ve 3 aylık tedavi sonrasında 12 kanallı elektrokardiyografi ile değerlendirildi. Maksimum ve minimum P dalga süresi arasındaki fark PD olarak belirlendi. Paired samples t-test, Wilcoxon testi istatistiksel değerlendirme için kullanıldı. Bulgular: Tedavi sonrasında PD'da belirgin azalma izlendi (62.85±21.62'e karşı 44.28±18.03 msn, p=0.001). Tedavi süresinde herhangi bir yan etki izlenmedi. So...

show abstract

Effects of percutaneous mitral balloon valvuloplasty on P-wave dispersion in patients with mitral stenosis

Cited by 44 publications

References 17 publications

Assessment of interatrial dyssynchrony by Tissue Doppler Imaging in mitral stenosis: Effect of afterload reduction after balloon mitral valvuloplasty

Assessment of interatrial dyssynchrony by Tissue Doppler Imaging in mitral stenosis: Effect of afterload reduction after balloon mitral valvuloplasty

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

The effect of nebivolol on P wave duration and dispersion in patients with Behçet’s disease; a prospective single-arm controlled study

Contact Info

Product

Resources

About