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Published in: Journal of Interventional Cardiac Electrophysiology 3/2012

01-12-2012

Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose

Authors: Selim Ayhan, Serkan Ozturk, Aytekin Alcelik, Mehmet Fatih Ozlu, Alim Erdem, Tolga Memioglu, Mesut Ozdemir, Mehmet Yazici

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 3/2012

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Abstract

Background

Prolonging atrial conduction time, as measured by tissue Doppler imaging (TDI), is an independent predictor of new onset or recurrent atrial fibrillation (AF). We investigated atrial conduction time and cardiac mechanical function in patients with impaired fasting glucose (IFG) using echocardiography.

Methods

Thirty patients with IFG (19 males and 11 females; age, 46.9 ± 9.5 years) and 30 control subjects (18 males and 12 females; age, 46.7 ± 8.2 years) were included. Atrial conduction time was determined from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and lateral tricuspid annulus (PA tricuspid) by TDI. Inter- and intra-atrial electromechanical delays (EMDs) were calculated. Left atrial (LA) volumes were determined according to the biplane area–length method. LA mechanical function parameters were calculated.

Results

LA passive emptying volume and LA passive emptying fraction decreased significantly in patients with IFG as compared with control subjects (p < 0.001 and p < 0.001, respectively). PA lateral and PA septal durations were significantly higher in patients with IFG than in the control group. However, no difference in PA tricuspid duration was observed between the two groups. Inter- and intra-atrial EMDs were significantly higher in patients with IFG as compared with the control subjects (median [interquartile range], 34.0 [17.0] vs. 17.0 [4.0], p < 0.001 and 15.0 [8.5] vs. 7.5 [2.0], p < 0.001, respectively). Positive correlations were detected between both inter- and intra-atrial EMD and glucose levels (r = 0.76, p < 0.001 and r = 0.68, p < 0.001, respectively). Additionally, a multiple linear regression analysis revealed that glucose levels were independently associated with inter-atrial EMD (β = 0.753, p < 0.001).

Conclusion

We showed that IFG was associated with inter- and intra-atrial EMD. Our findings suggest that IFG is an etiological factor for the development of AF.
Literature
1.
go back to reference Chugh, S. S., Blackshear, J. L., Shen, W. K., Hammill, S. C., & Gersh, B. J. (2001). Epidemiology and natural history of atrial fibrillation: clinical implications. Journal of the American College of Cardiology, 37, 371–378.PubMedCrossRef Chugh, S. S., Blackshear, J. L., Shen, W. K., Hammill, S. C., & Gersh, B. J. (2001). Epidemiology and natural history of atrial fibrillation: clinical implications. Journal of the American College of Cardiology, 37, 371–378.PubMedCrossRef
2.
go back to reference Krahn, A. D., Manfreda, J., Tate, R. B., Mathewson, F. A., & Cuddy, T. E. (1995). The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. American Journal of Medicine, 98, 476–484.PubMedCrossRef Krahn, A. D., Manfreda, J., Tate, R. B., Mathewson, F. A., & Cuddy, T. E. (1995). The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. American Journal of Medicine, 98, 476–484.PubMedCrossRef
3.
go back to reference Diker, E., Aydogdu, S., Ozdemir, M., Kural, T., Polat, K., Cehreli, S., et al. (1996). Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease. The American Journal of Cardiology, 77(1), 96–98.PubMedCrossRef Diker, E., Aydogdu, S., Ozdemir, M., Kural, T., Polat, K., Cehreli, S., et al. (1996). Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease. The American Journal of Cardiology, 77(1), 96–98.PubMedCrossRef
4.
go back to reference Benjamin, E. J., Levy, D., Vaziri, S. M., D’Agostino, R. B., Belanger, A. J., & Wolf, P. A. (1994). Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA, 271(11), 840–844.PubMedCrossRef Benjamin, E. J., Levy, D., Vaziri, S. M., D’Agostino, R. B., Belanger, A. J., & Wolf, P. A. (1994). Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA, 271(11), 840–844.PubMedCrossRef
5.
go back to reference Tang, M., Zhang, S., Sun, Q., & Huang, C. (2007). Alterations in electrophysiology and tissue structure of the left atrial posterior wall in a canine model of atrial fibrillation caused by chronic atrial dilatation. Circulation Journal, 71, 1636–1642.PubMedCrossRef Tang, M., Zhang, S., Sun, Q., & Huang, C. (2007). Alterations in electrophysiology and tissue structure of the left atrial posterior wall in a canine model of atrial fibrillation caused by chronic atrial dilatation. Circulation Journal, 71, 1636–1642.PubMedCrossRef
6.
go back to reference Daubert, J. C., Pavin, D., Jauvert, G., & Mabo, P. (2004). Intra- and interatrial conduction delay: ımplications for cardiac pacing. Pacing and Clinical Electrophysiology, 27, 507–525.PubMedCrossRef Daubert, J. C., Pavin, D., Jauvert, G., & Mabo, P. (2004). Intra- and interatrial conduction delay: ımplications for cardiac pacing. Pacing and Clinical Electrophysiology, 27, 507–525.PubMedCrossRef
7.
go back to reference American Diabetes Association. (2011). Diagnosis and classification of diabetes mellitus. Diabetes Care, 34(1), 62–69.CrossRef American Diabetes Association. (2011). Diagnosis and classification of diabetes mellitus. Diabetes Care, 34(1), 62–69.CrossRef
8.
go back to reference Coutinho, M., Gerstein, H. C., Wang, Y., & Yusuf, S. (1999). The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care, 22, 233–240.PubMedCrossRef Coutinho, M., Gerstein, H. C., Wang, Y., & Yusuf, S. (1999). The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care, 22, 233–240.PubMedCrossRef
9.
go back to reference Kannel, W. B., & McGee, D. L. (1979). Diabetes and cardiovascular disease. The Framingham Study. JAMA, 241, 2035–2038.PubMedCrossRef Kannel, W. B., & McGee, D. L. (1979). Diabetes and cardiovascular disease. The Framingham Study. JAMA, 241, 2035–2038.PubMedCrossRef
10.
go back to reference Kato, T., Yamashita, T., Sekiguchi, A., Sagara, K., Takamura, M., Takata, S., et al. (2006). What are arrhythmogenic substrates in diabetic rat atria? Journal of Cardiovascular Electrophysiology, 17, 890–894.PubMedCrossRef Kato, T., Yamashita, T., Sekiguchi, A., Sagara, K., Takamura, M., Takata, S., et al. (2006). What are arrhythmogenic substrates in diabetic rat atria? Journal of Cardiovascular Electrophysiology, 17, 890–894.PubMedCrossRef
11.
go back to reference Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., et al. (2005). Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18, 1440–1463.PubMedCrossRef Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., et al. (2005). Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18, 1440–1463.PubMedCrossRef
12.
go back to reference Dilaveris, P. E., Gialafos, E. J., Sideris, S. K., Theopistou, A. M., Andrikopoulos, G. K., Kyriakidis, M., et al. (1998). Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. American Heart Journal, 135, 733–738.PubMedCrossRef Dilaveris, P. E., Gialafos, E. J., Sideris, S. K., Theopistou, A. M., Andrikopoulos, G. K., Kyriakidis, M., et al. (1998). Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. American Heart Journal, 135, 733–738.PubMedCrossRef
13.
go back to reference Omi, W., Nagai, H., Takamura, M., Okura, S., Okajima, M., Furusho, H., et al. (2005). Doppler tissue analysis of atrial electromechanical coupling in paroxysmal atrial fibrillation. Journal of the American Society of Echocardiography, 18(1), 39–44.PubMedCrossRef Omi, W., Nagai, H., Takamura, M., Okura, S., Okajima, M., Furusho, H., et al. (2005). Doppler tissue analysis of atrial electromechanical coupling in paroxysmal atrial fibrillation. Journal of the American Society of Echocardiography, 18(1), 39–44.PubMedCrossRef
14.
go back to reference Fuller, J. H., Shipley, M. J., Rose, G., Jarrett, R. J., & Keen, H. (1980). Coronary heart disease risk and impaired glucose tolerance. The Whitehall study. Lancet, 1(8183), 1373–1376.PubMedCrossRef Fuller, J. H., Shipley, M. J., Rose, G., Jarrett, R. J., & Keen, H. (1980). Coronary heart disease risk and impaired glucose tolerance. The Whitehall study. Lancet, 1(8183), 1373–1376.PubMedCrossRef
15.
go back to reference Bucala, R., Tracey, K. J., & Cerami, A. (1991). Advanced glycosylation products quench nitric oxide and mediate defective endothelium-dependent vasodilatation in experimental diabetes. The Journal of Clinical Investigation, 87, 432–438.PubMedCrossRef Bucala, R., Tracey, K. J., & Cerami, A. (1991). Advanced glycosylation products quench nitric oxide and mediate defective endothelium-dependent vasodilatation in experimental diabetes. The Journal of Clinical Investigation, 87, 432–438.PubMedCrossRef
16.
go back to reference De Vos, C. B., Weijs, B., Crijns, H. J., Cheriex, E. C., Palmans, A., Habets, J., et al. (2009). Atrial tissue Doppler imaging for prediction of new-onset atrial fibrillation. Heart, 95, 835–840.PubMedCrossRef De Vos, C. B., Weijs, B., Crijns, H. J., Cheriex, E. C., Palmans, A., Habets, J., et al. (2009). Atrial tissue Doppler imaging for prediction of new-onset atrial fibrillation. Heart, 95, 835–840.PubMedCrossRef
17.
go back to reference Park, S. M., Kim, Y. H., Choi, J. I., Pak, H. N., Kim, Y. H., & Shim, W. J. (2010). Left atrial electromechanical conduction time can predict six-month maintenance of sinus rhythm after electrical cardioversion in persistent atrial fibrillation by Doppler tissue echocardiography. Journal of the American Society of Echocardiography, 23, 309–314.PubMedCrossRef Park, S. M., Kim, Y. H., Choi, J. I., Pak, H. N., Kim, Y. H., & Shim, W. J. (2010). Left atrial electromechanical conduction time can predict six-month maintenance of sinus rhythm after electrical cardioversion in persistent atrial fibrillation by Doppler tissue echocardiography. Journal of the American Society of Echocardiography, 23, 309–314.PubMedCrossRef
18.
go back to reference Acar, G., Akcay, A., Sökmen, A., Özkaya, M., Güler, E., Sökmen, G., et al. (2009). Assessment of atrial electromechanical delay, diastolic functions, and left atrial mechanical functions in patients with type 1 diabetes mellitus. Journal of the American Society of Echocardiography, 22, 732–738.PubMedCrossRef Acar, G., Akcay, A., Sökmen, A., Özkaya, M., Güler, E., Sökmen, G., et al. (2009). Assessment of atrial electromechanical delay, diastolic functions, and left atrial mechanical functions in patients with type 1 diabetes mellitus. Journal of the American Society of Echocardiography, 22, 732–738.PubMedCrossRef
19.
go back to reference Pala, S., Tigen, K., Karaahmet, T., Dundar, C., Kilicgedik, A., Güler, A., et al. (2010). Assessment of atrial electromechanical delay by tissue Doppler echocardiography in patients with nonischemic dilated cardiomyopathy. Journal of Electrocardiology, 43, 344–350.PubMedCrossRef Pala, S., Tigen, K., Karaahmet, T., Dundar, C., Kilicgedik, A., Güler, A., et al. (2010). Assessment of atrial electromechanical delay by tissue Doppler echocardiography in patients with nonischemic dilated cardiomyopathy. Journal of Electrocardiology, 43, 344–350.PubMedCrossRef
20.
go back to reference Akcay, A., Acar, G., Suner, A., Somken, A., Somken, G., Nacar, A. B., et al. (2009). Effects of slow coronary artery flow on P-wave dispersion and atrial electromechanical coupling. Journal of Electrocardiology, 42, 328–333.PubMedCrossRef Akcay, A., Acar, G., Suner, A., Somken, A., Somken, G., Nacar, A. B., et al. (2009). Effects of slow coronary artery flow on P-wave dispersion and atrial electromechanical coupling. Journal of Electrocardiology, 42, 328–333.PubMedCrossRef
21.
go back to reference Chao, T. F., Suenari, K., Chang, S. L., Lin, Y. J., Lo, L. W., Hu, Y. F., et al. (2010). Atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation associated with diabetes mellitus or impaired fasting glucose. The American Journal of Cardiology, 106(11), 1615–1620.PubMedCrossRef Chao, T. F., Suenari, K., Chang, S. L., Lin, Y. J., Lo, L. W., Hu, Y. F., et al. (2010). Atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation associated with diabetes mellitus or impaired fasting glucose. The American Journal of Cardiology, 106(11), 1615–1620.PubMedCrossRef
22.
go back to reference Henry, W. L., Morganroth, J., Pearlman, A. S., Clark, C. E., Redwood, D. R., Itscoitz, S. B., et al. (1976). Relation between echocardiographically determined left atrial size and atrial fibrillation. Circulation, 53, 273–279.PubMedCrossRef Henry, W. L., Morganroth, J., Pearlman, A. S., Clark, C. E., Redwood, D. R., Itscoitz, S. B., et al. (1976). Relation between echocardiographically determined left atrial size and atrial fibrillation. Circulation, 53, 273–279.PubMedCrossRef
23.
go back to reference Stahrenberg, R., Edelmann, F., Mende, M., Kockskämper, A., Düngen, H. D., & Scherer, M. (2010). Association of glucose metabolism with diastolic function along the diabetic continuum. Diabetologia, 53, 1331–1340.PubMedCrossRef Stahrenberg, R., Edelmann, F., Mende, M., Kockskämper, A., Düngen, H. D., & Scherer, M. (2010). Association of glucose metabolism with diastolic function along the diabetic continuum. Diabetologia, 53, 1331–1340.PubMedCrossRef
24.
go back to reference Tsang, T. S., Gersh, B. J., Appleton, C. P., Tajik, A. J., Barnes, M. E., Bailey, K. R., et al. (2002). Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women. Journal of the American College of Cardiology, 40(9), 1636–1644.PubMedCrossRef Tsang, T. S., Gersh, B. J., Appleton, C. P., Tajik, A. J., Barnes, M. E., Bailey, K. R., et al. (2002). Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women. Journal of the American College of Cardiology, 40(9), 1636–1644.PubMedCrossRef
Metadata
Title
Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose
Authors
Selim Ayhan
Serkan Ozturk
Aytekin Alcelik
Mehmet Fatih Ozlu
Alim Erdem
Tolga Memioglu
Mesut Ozdemir
Mehmet Yazici
Publication date
01-12-2012
Publisher
Springer US
Published in
Journal of Interventional Cardiac Electrophysiology / Issue 3/2012
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-012-9722-1

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