Immediate effect of percutaneous transvenous mitral commissurotomy on atrial electromechanical delay and P-wave dispersion in patients with severe mitral stenosis

详细信息    查看全文

• 作者：Jahangir Rashid Beig^a ; ^{jahangir3582@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Nisar A. Tramboo^b ; Hilal A. Rather^c ; Imran Hafeez^d ; Vijai Ananth^e ; Ajaz A. Lone^f ; Irfan Yaqoob^a ; Irfan A. Bhat^a ; Muzaffar Ali^e
• 关键词：Atrial electromechanical delay ; Mitral stenosis ; P-wave dispersion ; Percutaneous transvenous mitral commissurotomy
• 刊名：Indian Heart Journal
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：67
• 期：supp_S2
• 页码：S46-S54
• 全文大小：890 K

文摘

Mitral stenosis (MS) is associated with prolonged inter- and intra-atrial electromechanical delays and increased P-wave dispersion, which are markers of atrial fibrillation (AF) risk. This study was conducted to assess the immediate effect of successful percutaneous transvenous mitral commissurotomy (PTMC) on these parameters.

Methods

This single center observational study included 25 patients with severe MS (aged 34.1 ± 7.1 years, with mean mitral valve area (MVA) of 0.74 ± 0.13  cm²), in sinus rhythm, who underwent successful PTMC at our hospital. P-wave dispersion (PWD) was calculated by subtracting minimum P-wave duration (P_min) from maximum P-wave duration (P_max), measured on a 12-lead surface ECG obtained from each patient in supine position at a paper speed of 50 mm/s and 20 mm/mV. Inter-atrial (AEMD), left intra-atrial (L-IAEMD), and right intra-atrial (R-IAEMD) electromechanical delays were measured on tissue Doppler imaging. PTMC was performed using the standard Inoue Balloon technique. All these parameters were evaluated and compared before and 24–48 h after PTMC.

Results

Successful PTMC led to significant reduction in AEMD (p < 0.001), L-IAEMD (p < 0.001), and R-IAEMD (p < 0.001). There were no changes in P_max, P_min, and PWD immediately after PTMC.

Conclusions

Successful PTMC has a favorable early impact on inter- and intra-atrial electromechanical delays, which are considered as novel parameters of atrial electromechanical remodeling in MS patients. Prospective large-scale studies are required to confirm whether improvement in these markers translates into reduced long-term AF risk.