Relationships between P wave dispersion, atrial electromechanical delay, left atrial remodeling, and NT-proBNP levels, in patients with hypertrophic cardiomyopathy

Abstract

Background: We evaluated the associations among the well-known atrial fibrillation (AF) predictors including P-wave dispersion (PWD), intra-and inter-atrial electromechanical dyssynchrony (EMD), left atrial (LA) phasic functions, and plasma N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels, in patients with hypertrophic cardiomyopathy (HCM p = 0.001), p = 0.03), p = 0.006), but not, however, to LAAEFr (p = 0.4). The plasma NT-proBNP levels of patients were not correlated with either (Cardiol J 2015; 22, 1: 94-100)

Predictors of Future Atrial Fibrillation Development in Patients with Hypertrophic Cardiomyopathy: A Prospective Follow‐Up Study

“…Our data support that structural remodeling in the LA of HCM patients causes heterogeneity in propagation of atrial impulses which leads to vulnerability to atrial reentry as previously speculated . We previously showed that prolonged PWD was related to impaired LA reservoir functions in HCM . We entered PWD and LA phasic functions in a multivariate analysis which showed that the structural impairment of LA does not only play a role in AF development but also electrical LA remodeling observed in the disease spectrum may have a role in promoting AF.…”

“…P‐wave dispersion was calculated as previously described . Briefly, a 12‐lead resting surface ECG was obtained from all patients (lying supine) at a paper speed of 50 mm/sec and a signal size of 20 mm/mV, during SR, using a computer‐based ECG system.…”

“…Electrocardiographic Measurement: P-wave dispersion was calculated as previously described. 7 Briefly, a 12-lead resting surface ECG was obtained from all patients (lying supine) at a paper speed of 50 mm/sec and a signal size of 20 mm/mV, during SR, using a computer-based ECG system. Paper printouts of all 12 ECG leads were scanned using a high-resolution scanner (Samsung SCX-4200 Multifunction, 600 9 600 dpi, Samsung Electronics Co., Ltd., Tokyo, Japan), transferred into computer memory, and opened using a high-performance graphic program (Autodesk AutoCAD 2011, Autodesk, Inc., San Rafael, CA, USA).…”

“…LA dysfunction, termed secondary atrial myopathy, has been observed in patients with HCM due to exposure of the atrium to elevated left ventricular (LV) filling pressure for a long period . Structural changes in the LA cause electrical remodeling which contributes to prolongation of P‐wave . Calculation of P‐wave dispersion (PWD) on surface electrocardiogram provides noninvasive assessment of atrial electrical remodeling and prolonged PWD was found a predictor of AF .…”

“…6 Structural changes in the LA cause electrical remodeling which contributes to prolongation of P-wave. 7 Calculation of P-wave dispersion (PWD) on surface electrocardiogram provides noninvasive assessment of atrial electrical remodeling and prolonged PWD was found a predictor of AF. 8 Plasma natriuretic peptide (NT-proBNP) levels are related to impaired LA phasic functions in patients with HCM.…”