Influence of menstrual cycle on P wave dispersion

Karabag T. | Hanci V. | Aydin M. | Dogan S.M. | Turan I.O. | Yildirim N. | Gudul N.E.

Article | 2011 | International Heart Journal52 ( 1 ) , pp.23 - 26

Female gender is an independent risk factor for some types of arrhythmias. We sought to determine whether the menstrual cycle affects P wave dispersion, which is a predictor of atrial fibrillation. The study population consisted of 59 women in follicular phase (mean age, 29.3 ± 7.7 years) (group F) and 53 women in luteal phase (mean age, 28.1 ± 6.8 years) (group L). The ECGs of 35 patients (mean age, 26.4 ± 4.5) were obtained in both follicular and luteal phase. Both groups underwent a standard 12-lead surface electrocardiogram recorded at 50 mm/s. Maximal (Pmax) and minimal P wave durations (Pmin) were measured. P wave dispersion ( . . .PD) was defined as the difference between Pmax and Pmin. PD was significantly higher in group L than group F (46.6 ± 18.5 versus 40.1 ± 12.7; P < 0.05). Pmin was significantly lower in group L than group F (51.6 ± 12.1 versus 59.1 ± 12.1; P = 0.002). When we compared ECGs in different phases of the 35 patients, PD was significantly higher in luteal phase than follicular phase (53.2 ± 12.3 versus 42.8 ± 10.2; P < 0.05). Pmin was significantly lower in luteal phase than follicular phase (47.6 ± 6.6 versus 56 ± 10.1; P = 0.05). We detected a significant correlation between the day of the menses and PD (r = 0.27; P < 0.05). PD was increased in luteal phase compared to follicular phase, and this difference was more prominent as the days of the cycle progressed Daha fazlası Daha az

Evaluation of atrial electromechanical delay and left atrial mechanical function in patients with obstructive sleep apnea Cardiac involvement in patients with OSA

Karabag T. | Aydin M. | Altin R. | Dogan S.M. | Cil C. | Buyukuysal C. | Sayin M.R.

Article | 2012 | Wiener Klinische Wochenschrift124 ( 13-14 ) , pp.444 - 452

Objective The aim of this study was to evaluate atrial electromechanical delay measured by tissue Doppler imaging and left atrial mechanical function in patients with obstructive sleep apnea (OSA). Materials and methods Fourty-seven moderate-tosevere OSA patients who were newly diagnosed by poly-somnography (Apnea-hypopnea index ≥15 events/h, 32 males, mean age 49.4±11.5) and 30 patients who had no OSA in polysomnography (Apnea-hypopnea index<5 events/h, 21 males, mean age 45.4±9.1) were included in the study. Using tissue Doppler, diastolic functions, atrial electromechanical coupling were measured from the lateral mitral, se . . .ptal, and tricuspid annulus. Inter, intra, and left atrial electromechanical delay were calculated (lateral-tricuspid, septum-tricuspid, lateralseptal). Left atrial volumes (maximal, minimal, and presystolic) were measured by the method of discs in the apical four-chamber view and were indexed to body surface area. Mechanical function parameters of the left atrium were also calculated. Results Interatrial, intraatrial, and left atrial electromechanical delays were significantly higher in the OSA group compared to the control group. Passive emptying fraction was significantly decreased, volume at the beginning of atrial systole and active emptying volume were significantly increased in OSA patients compared to the controls. The apnea-hypopnea index was significantly associated with interatrial and intraatrial electromechanical delay, passive emptying fraction, and conduit volume. Conclusions Electromechanical delay was markedly prolonged and left atrial electromechanical function was impaired in untreated OSA patients. These impairments worsen with increasing severity of OSA. © Springer-Verlag Wien 2012 Daha fazlası Daha az

Prolonged P wave dispersion in pre-diabetic patients

Karabag T. | Aydin M. | Dogan S.M. | Ali Cetiner M. | Sayin M.R. | Gudul N.E. | Kucuk E.

Article | 2011 | Kardiologia Polska69 ( 6 ) , pp.566 - 571

Background: It is known that overt diabetes as well as chronic hyperglycaemia can lead to atrial fibrillation. A P wave dispersion (PWD) represents heterogeneity in atrial refractoriness. Aim: To investigate PWDs in patients with pre-diabetes. Method: Based on the results of examinations, 84 pre-diabetic patients (the pre-DM group; 50 female, 34 male; mean age 54 ± 8.6 years) who had no overt diabetes, coronary artery disease or hypertension, whose fasting blood glucose was higher than 100 mg/dL and/or whose 2 h glucose concentrations on an oral glucose tolerance test was in the range of 140 to 199 mg/dL, and 48 healthy volunteers ( . . .the non-DM group, 30 female, 18 male; mean age 51.7 ± 7.3 years) with no illnesses, were enrolled in this study. Standard 12-lead electrocardiograms of all patients were taken at 50 mm/s and 20 mm/mV standardisation. Maximum (Pmax) and minimum (P min) P-wave durations were measured. The PWD was defined as the difference between Pmax and Pmin. Results: The P max and PWD values were significantly higher in pre-DM compared to non-DM (104 ± 13 ms vs 98 ± 12 ms; p < 0.05, 42 ± 13 ms vs 34 ± 11 ms; p < 0.01 respectively). A positive correlation was found between PWD and fasting blood glucose (r = 0.32; p < 0.01). There was no correlation between PWD and HbA1c levels (r = 19; p > 0.05). Multivariate regression analysis showed no relationship between PWD and age, left atrial diameter, E, A, E/A or HbA1c. However, there was a relationship between PWD and fasting blood glucose. Conclusions: The Pmax and PWD are increased in pre-diabetic patients who have no coronary artery disease, hypertension or left ventricular hypertrophy. Copyright © Polskie Towarzystwo Kardiologiczne Daha fazlası Daha az

Predictors of atrial fibrillation after coronary artery bypass surgery

Dogan S.M. | Buyukates M. | Kandemir O. | Aydin M. | Gursurer M. | Acikgoz S. | Yavuzer R.

Article | 2007 | Coronary Artery Disease18 ( 5 ) , pp.327 - 331

OBJECTIVE: Atrial fibrillation is one of the most common arrhythmias associated with not only increased morbidity after coronary artery bypass grafting but also increased healthcare costs. Many factors are associated with atrial fibrillation onset after coronary artery bypass grafting. We prospectively examined which factors could predict atrial fibrillation after coronary artery bypass grafting. METHODS: Fifty-seven consecutive patients (37 men, mean age=60.2±12 years) with sinus rhythm before coronary artery bypass grafting are included the study. Clinical, demographic, laboratory and echocardiographic characteristics are all eval . . .uated prospectively. The maximum and minimum P-wave duration (Pmax and Pmin) were measured from the 12-lead surface electrocardiogram. The difference between the Pmax and the Pmin was calculated and defined as P-wave dispersion. Preoperative venous blood samples were taken for N-terminal proBrain natriuretic peptide level analysis. RESULTS: Ten (17%) patients had postoperative atrial fibrillation. Patients with postoperative atrial fibrillation were older (69.4±6 versus 58.2±12 years, P=0.01), had lower ejection fraction (44.1±8.9% versus 54.3±9; P=0.002), higher proBrain natriuretic peptide levels (538±136 pg/ml versus 293±359 pg/ml; P=0.03), longer Pmax (142.2±13.7 ms versus 120.8±21.2 ms; P=0.006) and longer P-wave dispersion (55.0±8.2 ms versus 41.3±14.3 ms; P=0.008) compared with the patients without atrial fibrillation. Univariate analysis showed that increased age (P=0.01), lower ejection fraction (P=0.02), enlargement of left atrium (P=0.02), increased Pmax (P=0.006) and increased P-wave dispersion (P=0.008) and increased level of preoperative proBrain natriuretic peptide (P=0.03) were associated with postoperative atrial fibrillation. Positive correlation was seen between the age and level of proBrain natriuretic peptide (r=0.322 and P=0.015). In multivariate analysis, age (P=0.05), lower ejection fraction (P=0.03), left atrial enlargement (P=0.05), longer Pmax (P=0.01) and P-wave dispersion (P=0.01) were found to be independent predictors of postoperative atrial fibrillation. CONCLUSION: Age, poor left ventricular functions, Pmax and P-wave dispersion are found to be independent predictors of atrial fibrillation after coronary artery bypass grafting. © 2007 Lippincott Williams & Wilkins, Inc Daha fazlası Daha az

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