Evaluation of echocardiographic associates of interatrial block in patients with essential hypertension

Öz

Objective: Myocardial fibrosis may cause conduction delays in hypertensive patients. Interatrial block (IAB), defined as a conduction delay between the right and left atrium, has been associated with cardiovascular events. In this study, we aimed to investigate the echocardiographic determinants of IAB in patients suffering from essential hypertension.

Materials and Methods: The population of this study included a total of 220 patients [male: 93 (42.3%), mean age: 61.8±7.8 years] with hypertension. IAB means a P wave duration of ≥120 ms on 12-lead electrocardiography recordings. Transthoracic echocardiography was used to evaluate all patients.

Results: IAB was revealed in 70 patients using electrocardiography. Both groups had similar demographic characteristics of the patients with and without IAB. There was a significant increase in interventricular septal thickness, posterior wall thickness, left atrial diameter (LAD), left ventricular mass, left ventricular mass index and the prevalence of left ventricular hypertrophy (LVH) among hypertensive patients with IAB. Independent predictors of IAB included increased LAD (OR=1.082; 95%CI: 1.006-1.164; p=0.034) and the presence of LVH (OR=3.051; 95%CI: 1.164-7.994; p=0.023). LAD values above 38 mm predicted IAB with a specificity of 58% and a sensitivity of 68% in the analyses of receiver operating characteristic curve (area under curve= 0.678; 95% confidence interval: 0.601-0.754; p<0.001).

Conclusion: There is a significant relationship between the presence of IAB and echocardiographic parameters related to LVH and left atrial dilatation among the patients suffering from essential hypertension. The IAB may be used as an electrocardiographic marker of myocardial fibrosis and cardiac remodeling among hypertensive patients.

Anahtar Kelimeler

• Echocardiography
• Electrocardiography
• Hypertension
• Interatrial Block

Esansiyel hipertansiyonu olan hastalarda interatriyal blok ile ilişkili ekokardiyografik bulguların değerlendirilmesi

Öz

Amaç: Miyokardiyal fibrozis hipertansif hastalarda ileti gecikmelerine neden olabilir. Sağ ve sol atriyumlar arasında ileti gecikmesi olarak tanımlanan interatriyal blok (İAB) kardiyovasküler olaylarla ilişkilendirilmiştir. Bu çalışmada, esansiyel hipertansiyonu olan hastalarda İAB için ekokardiyografik belirleyicilerin araştırılması amaçlanmıştır.

Gereç ve Yöntemler: Çalışma topluluğu toplam 220 hipertansif hastadan oluşturuldu [93 (%42,3) erkek, ortalama yaş 61,8±7,8 yıl]. İAB, 12 derivasyonlu EKG kaydında P dalgasının ≥120 msn olması olarak tanımlandı. Tüm hastalar transtorasik ekokardiyografi ile değerlendirildi.

Bulgular: İAB varlığı ekokardiyografi ile 70 hastada gösterildi. İAB olan ve olmayan hasta grupları benzer demografik özelliklere sahipti. İAB olan hipertansif hastalarda interventriküler septum kalınlığı, arka duvar kalınlığı, sol atriyum çapı, sol ventrikül kütlesi, sol ventrikül hipertrofisi (SVH) sıklığı ve sol ventrikül kütle indeksinde anlamlı artış saptandı. Artmış sol atriyum çapı (Rölatif Risk (RR)=1,082; %95 Güven Aralığı (GA): 1,006-1,164; p=0,034) ve SVH varlığı (RR=3,051; %95 GA: 1,164-7,994; p=0,023) İAB için bağımsız öngördürücüler olarak tespit edildi. ROC eğrisi analizinde 38 mm üzerindeki sol atriyum çapı değerleri İAB varlığını %58 özgüllük ve %68 duyarlılık ile öngörmektedir (Eğri altındaki alan = 0,678; %95 GA: 0,601-0,754; p<0,001).

Sonuç: Esansiyel hipertansiyonu olan hastalarda İAB varlığı ile SVH ve sol atriyum dilatasyonu ile ilgili ekokardiyografik parametreler arasında anlamlı bir ilişki bulunmaktadır. İAB, hipertansif hastalarda miyokardiyal fibrozis ve kardiyak yeniden modelleme için elektrokardiyografik bir belirteç olarak kullanılabilir.

Anahtar Kelimeler

• ekokardiyografi
• Elektrokardiyografi
• Hipertansiyon
• İnteratriyal Blok

Kaynakça

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