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Evaluating functional capacity, and mortality effects in the presence of atrial electromechanical conduction delay in patients with systolic heart failure [Anatol J Cardiol]
Anatol J Cardiol. 2016; 16(8): 579-586 | DOI: 10.5152/AnatolJCardiol.2015.6445  

Evaluating functional capacity, and mortality effects in the presence of atrial electromechanical conduction delay in patients with systolic heart failure

Murat Bilgin1, Bekir Serhat Yıldız2, Kamil Tülüce3, İlker Gül4, Mustafa Beyazıt Alkan5, Ahmet Sayın6, Aysel İslamlı5, Tolga Han Efe1, Yusuf İzzettin Alihanoğlu2, Mehdi Zoghi5, Mustafa Akın5
1Department Of Cardiology, Ankara Dışkapı Training And Research Hospital, Ankara- Turkey
2Department Of Cardiology, Faculty Of Medicine, Pamukkale University, Denizli- Turkey
3Department Of Cardiology, İzmir Karşıyaka State Hospital, İzmir- Turkey
4Department Of Cardiology, Faculty Of Medicine, İzmir Şifa University, İzmir- Turkey
5Department Of Cardiology, Faculty Of Medicine, Ege University, İzmir- Turkey
6Department Of Cardiology, İzmir Tepecik Training And Research Hospital, İzmir- Turkey

Objective: Atrial functions are relatively suppressed in heart failure (HF). We aimed to investigate the associations of intra- and inter-atrial electromechanical conduction delay (EMCD) with functional class and mortality over a 12-month follow-up period.
Methods: The prospective study included 65 patients with systolic HF and 65 healthy subjects with normal sinus rhythm. Left ventricular (LV) systolic functions and left atrial (LA) dimensions and volumes were evaluated by transthoracic echocardiography. Tissue Doppler imaging (TDI) signals at the lateral border of the mitral annulus (lateral PA'), septal mitral annulus (septal PA'), and tricuspid annulus (tricuspid PA') were measured. Intra- and inter-atrial EMCD were calculated.
Results: Mitral inflow velocities were studied using pulsed-wave Doppler after placing the sample volume at the leaflets’ tips. The peak early (E wave) and late (A wave) velocities were measured. The septal annular E/E' ratio was relatively higher and lateral, septal, and right ventricular S, E', and A' waves were significantly lower in the HF group than in the control group (12.49±6.03 – 7.16±1.75, pE/E' <0.0001). Intra-atrial EMCD was detected as 117.5 ms and inter-atrial EMCD as 127.5 ms in patients with prolonged atrial EMCD. A significant increase was found in prolonged intraand inter-atrial EMCD according to functional capacity increase (p=0.012 and p=0.031, respectively). The incidence of mortality was significantly higher in patients with prolonged atrial EMCD (p=0.025), and 5 patients in the HF group died during the study over the 12-month follow-up period.
Conclusions: In this study, we found a relationship between prolonged atrial conduction time and increased functional class and mortality in patients with systolic HF. (Anatol J Cardiol 2016; 16: 000-00)

Keywords: heart failure, atrial electromechanical delay, functional class, mortality


Murat Bilgin, Bekir Serhat Yıldız, Kamil Tülüce, İlker Gül, Mustafa Beyazıt Alkan, Ahmet Sayın, Aysel İslamlı, Tolga Han Efe, Yusuf İzzettin Alihanoğlu, Mehdi Zoghi, Mustafa Akın. Evaluating functional capacity, and mortality effects in the presence of atrial electromechanical conduction delay in patients with systolic heart failure. Anatol J Cardiol. 2016; 16(8): 579-586

Corresponding Author: Murat Bilgin, Türkiye


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