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Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Prolonging atrial conduction time, as measured by tissue Doppler imaging (TDI), is an independent predictor of new onset or recurrent atrial fibrillation (AF). We investigated atrial conduction time and cardiac mechanical function in patients with impaired fasting glucose (IFG) using echocardiography.

Methods

Thirty patients with IFG (19 males and 11 females; age, 46.9 ± 9.5 years) and 30 control subjects (18 males and 12 females; age, 46.7 ± 8.2 years) were included. Atrial conduction time was determined from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and lateral tricuspid annulus (PA tricuspid) by TDI. Inter- and intra-atrial electromechanical delays (EMDs) were calculated. Left atrial (LA) volumes were determined according to the biplane area–length method. LA mechanical function parameters were calculated.

Results

LA passive emptying volume and LA passive emptying fraction decreased significantly in patients with IFG as compared with control subjects (p < 0.001 and p < 0.001, respectively). PA lateral and PA septal durations were significantly higher in patients with IFG than in the control group. However, no difference in PA tricuspid duration was observed between the two groups. Inter- and intra-atrial EMDs were significantly higher in patients with IFG as compared with the control subjects (median [interquartile range], 34.0 [17.0] vs. 17.0 [4.0], p < 0.001 and 15.0 [8.5] vs. 7.5 [2.0], p < 0.001, respectively). Positive correlations were detected between both inter- and intra-atrial EMD and glucose levels (r = 0.76, p < 0.001 and r = 0.68, p < 0.001, respectively). Additionally, a multiple linear regression analysis revealed that glucose levels were independently associated with inter-atrial EMD (β = 0.753, p < 0.001).

Conclusion

We showed that IFG was associated with inter- and intra-atrial EMD. Our findings suggest that IFG is an etiological factor for the development of AF.

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References

  1. Chugh, S. S., Blackshear, J. L., Shen, W. K., Hammill, S. C., & Gersh, B. J. (2001). Epidemiology and natural history of atrial fibrillation: clinical implications. Journal of the American College of Cardiology, 37, 371–378.

    Article  PubMed  CAS  Google Scholar 

  2. Krahn, A. D., Manfreda, J., Tate, R. B., Mathewson, F. A., & Cuddy, T. E. (1995). The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. American Journal of Medicine, 98, 476–484.

    Article  PubMed  CAS  Google Scholar 

  3. Diker, E., Aydogdu, S., Ozdemir, M., Kural, T., Polat, K., Cehreli, S., et al. (1996). Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease. The American Journal of Cardiology, 77(1), 96–98.

    Article  PubMed  CAS  Google Scholar 

  4. Benjamin, E. J., Levy, D., Vaziri, S. M., D’Agostino, R. B., Belanger, A. J., & Wolf, P. A. (1994). Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA, 271(11), 840–844.

    Article  PubMed  CAS  Google Scholar 

  5. Tang, M., Zhang, S., Sun, Q., & Huang, C. (2007). Alterations in electrophysiology and tissue structure of the left atrial posterior wall in a canine model of atrial fibrillation caused by chronic atrial dilatation. Circulation Journal, 71, 1636–1642.

    Article  PubMed  Google Scholar 

  6. Daubert, J. C., Pavin, D., Jauvert, G., & Mabo, P. (2004). Intra- and interatrial conduction delay: ımplications for cardiac pacing. Pacing and Clinical Electrophysiology, 27, 507–525.

    Article  PubMed  Google Scholar 

  7. American Diabetes Association. (2011). Diagnosis and classification of diabetes mellitus. Diabetes Care, 34(1), 62–69.

    Article  Google Scholar 

  8. Coutinho, M., Gerstein, H. C., Wang, Y., & Yusuf, S. (1999). The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care, 22, 233–240.

    Article  PubMed  CAS  Google Scholar 

  9. Kannel, W. B., & McGee, D. L. (1979). Diabetes and cardiovascular disease. The Framingham Study. JAMA, 241, 2035–2038.

    Article  PubMed  CAS  Google Scholar 

  10. Kato, T., Yamashita, T., Sekiguchi, A., Sagara, K., Takamura, M., Takata, S., et al. (2006). What are arrhythmogenic substrates in diabetic rat atria? Journal of Cardiovascular Electrophysiology, 17, 890–894.

    Article  PubMed  Google Scholar 

  11. Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., et al. (2005). Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18, 1440–1463.

    Article  PubMed  Google Scholar 

  12. Dilaveris, P. E., Gialafos, E. J., Sideris, S. K., Theopistou, A. M., Andrikopoulos, G. K., Kyriakidis, M., et al. (1998). Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. American Heart Journal, 135, 733–738.

    Article  PubMed  CAS  Google Scholar 

  13. Omi, W., Nagai, H., Takamura, M., Okura, S., Okajima, M., Furusho, H., et al. (2005). Doppler tissue analysis of atrial electromechanical coupling in paroxysmal atrial fibrillation. Journal of the American Society of Echocardiography, 18(1), 39–44.

    Article  PubMed  Google Scholar 

  14. Fuller, J. H., Shipley, M. J., Rose, G., Jarrett, R. J., & Keen, H. (1980). Coronary heart disease risk and impaired glucose tolerance. The Whitehall study. Lancet, 1(8183), 1373–1376.

    Article  PubMed  CAS  Google Scholar 

  15. Bucala, R., Tracey, K. J., & Cerami, A. (1991). Advanced glycosylation products quench nitric oxide and mediate defective endothelium-dependent vasodilatation in experimental diabetes. The Journal of Clinical Investigation, 87, 432–438.

    Article  PubMed  CAS  Google Scholar 

  16. De Vos, C. B., Weijs, B., Crijns, H. J., Cheriex, E. C., Palmans, A., Habets, J., et al. (2009). Atrial tissue Doppler imaging for prediction of new-onset atrial fibrillation. Heart, 95, 835–840.

    Article  PubMed  Google Scholar 

  17. Park, S. M., Kim, Y. H., Choi, J. I., Pak, H. N., Kim, Y. H., & Shim, W. J. (2010). Left atrial electromechanical conduction time can predict six-month maintenance of sinus rhythm after electrical cardioversion in persistent atrial fibrillation by Doppler tissue echocardiography. Journal of the American Society of Echocardiography, 23, 309–314.

    Article  PubMed  Google Scholar 

  18. Acar, G., Akcay, A., Sökmen, A., Özkaya, M., Güler, E., Sökmen, G., et al. (2009). Assessment of atrial electromechanical delay, diastolic functions, and left atrial mechanical functions in patients with type 1 diabetes mellitus. Journal of the American Society of Echocardiography, 22, 732–738.

    Article  PubMed  Google Scholar 

  19. Pala, S., Tigen, K., Karaahmet, T., Dundar, C., Kilicgedik, A., Güler, A., et al. (2010). Assessment of atrial electromechanical delay by tissue Doppler echocardiography in patients with nonischemic dilated cardiomyopathy. Journal of Electrocardiology, 43, 344–350.

    Article  PubMed  Google Scholar 

  20. Akcay, A., Acar, G., Suner, A., Somken, A., Somken, G., Nacar, A. B., et al. (2009). Effects of slow coronary artery flow on P-wave dispersion and atrial electromechanical coupling. Journal of Electrocardiology, 42, 328–333.

    Article  PubMed  Google Scholar 

  21. Chao, T. F., Suenari, K., Chang, S. L., Lin, Y. J., Lo, L. W., Hu, Y. F., et al. (2010). Atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation associated with diabetes mellitus or impaired fasting glucose. The American Journal of Cardiology, 106(11), 1615–1620.

    Article  PubMed  CAS  Google Scholar 

  22. Henry, W. L., Morganroth, J., Pearlman, A. S., Clark, C. E., Redwood, D. R., Itscoitz, S. B., et al. (1976). Relation between echocardiographically determined left atrial size and atrial fibrillation. Circulation, 53, 273–279.

    Article  PubMed  CAS  Google Scholar 

  23. Stahrenberg, R., Edelmann, F., Mende, M., Kockskämper, A., Düngen, H. D., & Scherer, M. (2010). Association of glucose metabolism with diastolic function along the diabetic continuum. Diabetologia, 53, 1331–1340.

    Article  PubMed  CAS  Google Scholar 

  24. Tsang, T. S., Gersh, B. J., Appleton, C. P., Tajik, A. J., Barnes, M. E., Bailey, K. R., et al. (2002). Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women. Journal of the American College of Cardiology, 40(9), 1636–1644.

    Article  PubMed  Google Scholar 

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Conflict of interest

None of the authors have any potential conflict of interest or relevant disclosures.

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Authors and Affiliations

  1. Department of Cardiology, Abant Izzet Baysal University School of Medicine, Gölköy Yerleşkesi, 14280, Bolu, Turkey

    Selim Ayhan, Serkan Ozturk, Mehmet Fatih Ozlu, Alim Erdem, Tolga Memioglu, Mesut Ozdemir & Mehmet Yazici

  2. Department of Internal Medicine, Abant Izzet Baysal University School of Medicine, Bolu, Turkey

    Aytekin Alcelik

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  1. Selim Ayhan
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  2. Serkan Ozturk
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  3. Aytekin Alcelik
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  4. Mehmet Fatih Ozlu
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Correspondence to Selim Ayhan.

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The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, please see: http://www.textcheck.com/certificate/WtIvi2.

Editorial Commentary

This study demonstrated that left atrial passive emptying volume and fraction decreased significantly in patients with impaired fasting glucose compared to control subjects. Patients with impaired fasting glucose levels had longer inter- and intra-atrial conduction delays and glucose levels were independently associated with inter-atrial electromechanical delays. These findings suggest that impaired fasting glucose may be an etiologic factor in the development of atrial fibrillation.

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Ayhan, S., Ozturk, S., Alcelik, A. et al. Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose. J Interv Card Electrophysiol 35, 247–252 (2012). https://doi.org/10.1007/s10840-012-9722-1

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  • DOI: https://doi.org/10.1007/s10840-012-9722-1

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