Assessment of Atrial Conduction Time in Patients With Sarcoidosis

作者：Buyukoglan Hakan; Kaya Mehmet Gungor; Ardic Idris^*; Yarlioglues Mikail; Dogdu Orhan; Bol Canan; Sahin Omer; Kanbay Asiye; Koc Fatih; Ozdogru Ibrahim

来源：Journal of Investigative Medicine, 2011, 59(1): 15-21.

DOI：10.2310/jim.0b013e3182001680

• sarcoidosis
• atrial conduction time
• cardiac involvement
• echocardiography
• electrocardiography
• P wave

Objectives: Sarcoidosis is an inflammatory granulomatous disease of unknown cause that involves multiple organ systems. Myocardial involvement is usually associated with poor prognosis, but diagnosis of cardiac sarcoidosis is frequently difficult. The aim of this study was to investigate the atrial conduction time in patients with sarcoidosis by using high-usefulness tissue Doppler echocardiography.
Methods: The study population included 49 patients with sarcoidosis (19 men; mean age, 40.5 +/- 9.8 years; mean disease duration, 35.7 +/- 15.3 months) and 45 healthy control subjects (17 men; mean age, 40.7 +/- 7.2 years). From the 12-lead electrocardiogram, P wave dispersion (PWD) was calculated. The timing of atrial contractions (PA) was measured as the intervals between the onset of P wave on electrocardiogram and the beginning of A-wave on TDI, and atrial electromechanical delay (EMD) was calculated from the lateral (PA lateral) and septal (PA septal) mitral annulus and lateral tricuspid annulus (PA tricuspid).
Results: Both PA lateral and PA septal were significantly longer in patients with sarcoidosis than control subjects (67.9 +/- 16.1 vs 56.3 +/- 13.1, P < 0.001; and 54.8 +/- 15.2 vs 45.1 +/- 14.2 ms, P = 0.002, respectively). Intra-atrial (PA septal-PA tricuspid) and interatrial (PA lateral-PA tricuspid) EMD were significantly higher in sarcoidosis groups (12.6 +/- 7.5 vs 8.0 +/- 7.1, P = 0.003; and 25.7 +/- 9.8 vs 19.3 +/- 7.7 ms, P = 0.001, respectively). Similarly, maximum P-wave duration and PWD were significantly longer in patients with sarcoidosis than control subjects (105.2 +/- 11.8 vs 96.7 +/- 15.4, P = 0.004 and 24.7 +/- 5.6 vs 19.7 +/- 7.1 ms, P = 0.001, respectively). There were significant positive correlations between the disease duration and interatrial EMD (r = 0.56, P < 0.001) and intra-atrial EMD (r = 0.66, P < 0.001). Positive correlation also was present between the disease duration and PWD (r = .62, P < 0.001).
Conclusions: Atrial EMD was found prolonged in patients with sarcoidosis. We also have demonstrated that PWD, interatrial and intra-atrial EMD were significantly correlated with disease duration. This study calls attention to measurement of atrial conduction time that may be clinically helpful in the recognition of cardiac involvement.

• 出版日期2011-1