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Document Details : Title: P wave dispersion and atrial electromechanical delay: do they vary with the extent of mitral annular calcification? Author(s): I. Eweda , M. Abul-Saud , H. Fouad , R.N. Hanna , W. Nammas Journal: Acta Cardiologica Volume: 71 Issue: 4 Date: 2016 Pages: 449-455 DOI: 10.2143/AC.71.4.3159698 Abstract : Objectives: P wave dispersion and electromechanical delay increase in patients with mitral annulus calcification. We hypothesized that the degree of P wave dispersion and electromechanical delay increase with increasing extent of calcification. Methods and results: We enrolled 50 consecutive subjects with mitral annulus calcification documented by trans-thoracic echocardiography, and 50 matched controls. All subjects underwent 12-lead electrocardiography to measure P wave dispersion (maximum – minimum P wave duration), and tissue Doppler imaging to measure electromechanical delay. The time interval from the onset of the P wave on the electrocardiogram to the onset of the late diastolic a wave (PA interval) was obtained from the lateral and septal mitral annulus, and the tricuspid annulus. Inter-atrial and intra-atrial electromechanical delay were calculated as lateral PA - tricuspid PA, and septal PA - tricuspid PA, respectively. Mitral annulus calcification was assigned as mild, moderate and severe when it affected ≤ one-third, between one-third and two-thirds, and > two-thirds of the annulus, respectively. Mean age was 61.8 ± 9.8 years; 50% were males. Patients with mitral annulus calcification had greater P wave dispersion, inter-atrial and intra-atrial electromechanical delay, versus controls (P < 0.05 for all). There was a progressive increase of P wave dispersion with increasing extent of calcification (P < 0.05). Similarly, there was a progressive increase of lateral PA interval, inter-atrial and intra-atrial electromechanical delay with increasing extent of calcification (P < 0.05 for all). Conclusions: Patients with mitral annulus calcification had increased P wave dispersion and electromechanical delay, versus matched controls. P wave dispersion and electromechanical delay increased progressively with increasing extent of calcification. |
