P wave dispersion and atrial electromechanical delay: do they vary with the extent of mitral annular calcification?

EWEDA, Inas; ABUL-SAUD, Mona; FOUAD, Hany; HANNA, Rania N.; NAMMAS, Wail

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.

Acta Cardiologica, 2016, Vol 71, Issue 4, p449

0001-5385

Academic Journal

10.1080/AC.71.4.3159698