Impact of Percutaneous Mitral Balloon Valvuloplasty on P-Wave Dispersion in Patients with Rheumatic Mitral Stenosis

Yıl 2018, Cilt: 21 Sayı: 3, 225 - 229, 02.12.2018

Hicaz Zencirkıran Ağuş Serkan Kahraman

Öz

Introduction:
P-wave dispersion (PWD) is a new
electrocardiographic (ECG) index believed to reflect heterogeneous atrial
conduction with ECG leads of different orientation. Mitral stenosis (MS) is
associated with increased PWD, which are markers of atrial fibrillation (AF)
risk. The aim of the present study was to assess the immediate effect of
successful percutaneous mitral balloon valvuloplasty (PMBV) on these
parameters.

Patients
and Methods: Seventy patients
(98% females, aged 44 ± 12 years) with moderate or severe rheumatic MS and 60
healthy volunteers (95.7% females, aged 45 ± 11 years) as a control group were
enrolled in the study. 12-Lead ECGs were recorded for each patient 1 day before
PMBV to evaluate baseline maximum and minimum P-wave duration and PWD and
repeated within 72 h.

Results:
The maximum
P-wave duration (Pmax) and PWD in patients with MS were found to be
significantly higher than those in the control group (p< 0.001). ECG parameters
of P_max (142 (120-170) vs. 130 (110-164), p< 0.001) and PWD [45
(30-69) vs. 35 (16-57), p< 0.001] decreased in the acute period of PMBV
(p< 0.001). On the other hand, the procedure had no significant effect on
minimum P-wave duration (p= 0.111).

Conclusion:
Our
study has shown that P_max and PWD were significantly higher in
patients with MS than in healthy control subjects, and they decreased
significantly after successful PMBV. Further prospective long-term studies are
needed to confirm the relationship between atrial conduction velocities and
development of AF in patients with MS.

Anahtar Kelimeler

Mitral stenosis, percutaneous mitral balloon valvuloplasty, p-wave dispersion

Romatizmal Mitral Stenozlu Hastalarda Perkütan Mitral Balon Valvüloplastinin P Dalga Dispersiyonu Üzerine Etkisi

Öz

Giriş: P dalga dispersiyonu (PDD), farklı
elektrokardiyografi (EKG) leadlerinden heterojen atriyal iletiyi yansıttığına
inanılan yeni bir elektrokardiyografik indekstir. Mitral stenoz (MS), atriyal
fibrilasyon (AF)’un bir göstergesi
olan artmış PDD ile ilişkilidir. Çalışmamız başarılı perkütan mitral balon
valvüloplasti (PMBV)’nin bu
parametreler üzerine olan etkisini incelemek için tasarlandı.

Hastalar ve
Yöntem: Orta ve ciddi romatizmal mitral stenozu olan 70
(%98 kadın, ortalama yaş 44 ± 12) hasta ve 60 (%95.7 kadın, ortalama yaş 45 ±
11) sağlıklı kontrol grubu çalışmaya alındı. PMBV’den 1 gün önce ve yapıldıktan
sonra 72 saat içinde 12 derivasyonlu EKG çekilerek maksimum ve minimum P dalga
süresi, PDD hesaplandı.

Bulgular: Maksimum P dalga süresi 
ve PDD MS hastalarında kontrol grubuna göre anlamlı olarak fazla bulundu
(p< 0.001). P_max [142 (120-170) vs. 130 (110-164), p< 0.001] ve PDD [45 (30-69) vs. 35
(16-57), p< 0.00],
PMBV sonrası akut dönemde azaldı (p< 0.001). Diğer yandan işlemin minimum P
dalga süresi üzerine anlamlı etkisi olmadı (p= 0.111).

Sonuç: Çalışmamızda MS’li hastalarda P_max ve PDD’nin sağlıklı
kontrol grubuna göre anlamlı olarak fazla olduğunu ve başarılı PMBV sonrası
anlamlı derecede azaldığını gösterdik. MS’li hastalarda AF ile atriyal ileti
velositeleri arasındaki ilişkiyi doğrulamak için prospektif uzun dönem takipli
çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Mitral stenoz, perkütan mitral balon valvüloplasti, p dalga dispersiyonu

Kaynakça

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