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Published in: The International Journal of Cardiovascular Imaging 5/2009

01-06-2009 | Original Paper

Effect of treadmill exercise testing on P wave duration and dispersion in patients with isolated myocardial bridging

Authors: Irfan Barutcu, Ali Metin Esen, Ramazan Ozdemir, Nusret Acikgoz, Muhsin Turkmen, Cevat Kirma

Published in: The International Journal of Cardiovascular Imaging | Issue 5/2009

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Abstract

Several previous studies suggest that myocardial bridging (MB) is associated with ischemia and rhythm disturbances. We sought to examine exercise-induced changes in P wave duration and dispersion (PWD), the markers of atrial conduction abnormalities in patients with isolated MB of left anterior descending artery (LAD) and control subjects. Eighteen patients with MB of LAD (group-I) and 22 subjects with angiographically demonstrated normal coronary arteries (group-II) underwent treadmill exercise testing. Before and after exercise ECG was recorded at a paper speed of 50 mm/s. The change in maximum and minimum P wave duration was measured manually and difference between two values was defined as PWD. There was no difference between two groups in terms of demographic properties. Baseline maximum and minimum P wave duration and PWD durations were similar in both groups and they did not change after exercise. (Group-I: before and after test; 114 ± 10 vs. 114 ± 9, 66 ± 13 vs. 67 ± 10, and 47 ± 9 vs. 45 ± 13 ms, P > 0.05, group-II; 113 ± 9 vs. 115 ± 8, 68 ± 11 vs. 68 ± 11, 45 ± 11 vs. 48 ± 15 ms for each, respectively). In addition there was no significant correlation between PWD and P wave duration and echocardiographic variables. In patients with MB of LAD, PWD and P wave duration were not different than healthy subjects and treadmill exercise testing did not induce atrial conduction abnormalities in both groups.
Literature
1.
go back to reference Ge J, Erbel R, Rupprecht HJ et al (1994) Comparison of intravascular ultrasound and angiographic in the assessment of myocardial bridging. Circulation 89:1725–1732PubMed Ge J, Erbel R, Rupprecht HJ et al (1994) Comparison of intravascular ultrasound and angiographic in the assessment of myocardial bridging. Circulation 89:1725–1732PubMed
2.
go back to reference Schwarz ER, Klues HG, vom Dahl J, Klein I, Krebs W, Hanrath P (1997) Functional characteristics of myocardial bridging. A combined angiographic and intracoronary Doppler flow study. Eur Heart J 18:434–442PubMed Schwarz ER, Klues HG, vom Dahl J, Klein I, Krebs W, Hanrath P (1997) Functional characteristics of myocardial bridging. A combined angiographic and intracoronary Doppler flow study. Eur Heart J 18:434–442PubMed
4.
go back to reference Hill RC, Chitwood WR, Bashore TM, Sink JD, Cox JL, Wechsler AS (1981) Coronary flow and regional function before and after supraarterial myotomy for myocardial bridging. Ann Thorac Surg 31:176–181PubMed Hill RC, Chitwood WR, Bashore TM, Sink JD, Cox JL, Wechsler AS (1981) Coronary flow and regional function before and after supraarterial myotomy for myocardial bridging. Ann Thorac Surg 31:176–181PubMed
5.
go back to reference Agirbasli M, Martin GS, Stout JB, Jennings HSIII, Lea JWIV, Dixon JH Jr (1997) Myocardial bridge as a cause of thrombus formation and myocardial infarction in a young athlete. Clin Cardiol 20:1032–1036PubMedCrossRef Agirbasli M, Martin GS, Stout JB, Jennings HSIII, Lea JWIV, Dixon JH Jr (1997) Myocardial bridge as a cause of thrombus formation and myocardial infarction in a young athlete. Clin Cardiol 20:1032–1036PubMedCrossRef
6.
go back to reference den Dulk K, Brugada P, Braat S, Heddle B, Wellens HJ (1983) Myocardial bridging as a cause of paroxysmal atrioventricular block. J Am Coll Cardiol 1:965–969CrossRef den Dulk K, Brugada P, Braat S, Heddle B, Wellens HJ (1983) Myocardial bridging as a cause of paroxysmal atrioventricular block. J Am Coll Cardiol 1:965–969CrossRef
8.
go back to reference Morales AR, Romanelli R, Boucek RJ (1980) The mural left anterior descending coronary artery, strenuous exercise and sudden death. Circulation 62:230–237PubMed Morales AR, Romanelli R, Boucek RJ (1980) The mural left anterior descending coronary artery, strenuous exercise and sudden death. Circulation 62:230–237PubMed
17.
go back to reference Myrianthefs MM, Shandling AH, Startt-Selvester RH et al (1992) Analysis of the signal-averaged P-wave duration in patients with percutaneous coronary angioplasty-induced myocardial ischemia. Am J Cardiol 70:728–732. doi:10.1016/0002-9149(92)90549-E PubMedCrossRef Myrianthefs MM, Shandling AH, Startt-Selvester RH et al (1992) Analysis of the signal-averaged P-wave duration in patients with percutaneous coronary angioplasty-induced myocardial ischemia. Am J Cardiol 70:728–732. doi:10.​1016/​0002-9149(92)90549-E PubMedCrossRef
19.
go back to reference Kelly AE, Gensini GC (1975) Coronary arteriography and left heart study. Heart Lung 4:85–98PubMed Kelly AE, Gensini GC (1975) Coronary arteriography and left heart study. Heart Lung 4:85–98PubMed
20.
go back to reference James TN, Burch GE (1958) The atrial coronary arteries in men. Circulation 17:90–98PubMed James TN, Burch GE (1958) The atrial coronary arteries in men. Circulation 17:90–98PubMed
21.
go back to reference Flaker GC, Fletcher KA, Rothbart RM, Rothbart RM, Halperin JP, Hart RG (1995) Clinical and echocardiographic features of intermittent atrial fibrillation that predict recurrent atrial fibrillation. Am J Cardiol 76:355–358. doi:10.1016/S0002-9149(99)80100-3 PubMedCrossRef Flaker GC, Fletcher KA, Rothbart RM, Rothbart RM, Halperin JP, Hart RG (1995) Clinical and echocardiographic features of intermittent atrial fibrillation that predict recurrent atrial fibrillation. Am J Cardiol 76:355–358. doi:10.​1016/​S0002-9149(99)80100-3 PubMedCrossRef
22.
go back to reference Turitto G, Bandarizadeh B, Salciccioli L, Abordo MG Jr, Pizzarelli M, el-Sherif N (1998) Risk stratification for recurrent tachyarrhythmias in patients with paroxysmal atrial fibrillation and flutter: role of signal averaged electrocardiogram and echocardiography. Pacing Clin Electrophysiol 21:197–201. doi:10.1111/j.1540-8159.1998.tb01088.x PubMedCrossRef Turitto G, Bandarizadeh B, Salciccioli L, Abordo MG Jr, Pizzarelli M, el-Sherif N (1998) Risk stratification for recurrent tachyarrhythmias in patients with paroxysmal atrial fibrillation and flutter: role of signal averaged electrocardiogram and echocardiography. Pacing Clin Electrophysiol 21:197–201. doi:10.​1111/​j.​1540-8159.​1998.​tb01088.​x PubMedCrossRef
23.
go back to reference Henry WL, Morganroth J, Pearlman AS et al (1976) Relation between echocardiographically determined left atrial size and atrial fibrillation. Circulation 53:273–279PubMed Henry WL, Morganroth J, Pearlman AS et al (1976) Relation between echocardiographically determined left atrial size and atrial fibrillation. Circulation 53:273–279PubMed
25.
go back to reference Suttorp MJ, Kingma JH, Koomen EM, van’t Hof A, Tijssen JG, Lie KI (1993) Recurrence of paroxysmal atrial fibrillation or flutter after successful cardioversion in patients with normal left ventricular function. Am J Cardiol 71:710–713. doi:10.1016/0002-9149(93)91015-A PubMedCrossRef Suttorp MJ, Kingma JH, Koomen EM, van’t Hof A, Tijssen JG, Lie KI (1993) Recurrence of paroxysmal atrial fibrillation or flutter after successful cardioversion in patients with normal left ventricular function. Am J Cardiol 71:710–713. doi:10.​1016/​0002-9149(93)91015-A PubMedCrossRef
Metadata
Title
Effect of treadmill exercise testing on P wave duration and dispersion in patients with isolated myocardial bridging
Authors
Irfan Barutcu
Ali Metin Esen
Ramazan Ozdemir
Nusret Acikgoz
Muhsin Turkmen
Cevat Kirma
Publication date
01-06-2009
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 5/2009
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-009-9435-4

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