Pediatric Cardiology

, Volume 35, Issue 5, pp 857–862 | Cite as

Assessment of Atrial Electromechanical Delay Using Tissue Doppler Echocardiography in Children with Asthma

  • Murat Çiftel
  • Osman Yılmaz
  • Fırat Kardelen
  • Hasan Kahveci
Original Article
First Online:
Received:
Accepted:

Abstract

Right ventricular (RV) dysfunction, pulmonary hypertension, atrial enlargement, and cor pulmonale may be associated with asthma. These pathological conditions may disturb the electrophysiological properties of the right atrium. This study investigated the atrial electromechanical delay and P-wave dispersion (PWD) in patients with asthma. Thirty-four children aged 8–16 years who were being followed up for asthma constituted the patient group, and 34 age- and body mass index-matched patients constituted the control group. Both groups underwent RV tissue Doppler measurements, intra-right atrial conduction time (IRCT-echo) determination, intra-left atrial conduction time (ILCT-echo) determination, inter-atrial conduction time (IACT-echo) determination, and PWD measurement. The IRCT-echo (14.38 ± 5.46 and 8.20 ± 3.90 ms; p < 0.001) and IACT-echo (28.97 ± 6.58 and 22.79 ± 6.28 ms; p < 0.001) were higher in patients with asthma than in the control group. The PWD (44.58 ± 17.51 and 38.11 ± 13.50 ms; p = 0.09), maximum P-wave duration (87.94 ± 18.20 and 82.44 ± 16.36 ms, p = 0.19), minimum P-wave duration (43.58 ± 9.95 and 44.79 ± 9.13 ms; p = 0.60), and ILCT-echo (15.88 ± 5.40 and 14.58 ± 4.94 ms; p = 0.30) were similar between the two groups. The IRCT-echo was positively correlated with the isovolumetric relaxation time of the lateral tricuspid annulus (r = 0.60; p < 0.001) and with the myocardial performance index of the lateral tricuspid annulus (r = 0.59; p < 0.001) in patients with asthma. The IRCT-echo and IACT-echo were higher in patients with asthma than in the control group. The deterioration of the electrophysiological properties of the right atrium may result in a risk of atrial fibrillation in patients with asthma.

Keywords

Asthma Atrial electromechanical delay P-wave dispersion Atrial fibrillation Right ventricular dysfunction 
This is a preview of subscription content, log in to check access.

Notes

Conflicts of interest

None.

References

  1. 1.
    Bhardwaj R (2012) Atrial fibrillation in a tertiary care institute: a prospective study. Indian Heart J 64:476–478PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Bin Salih SA, Showlag MS, Al-Qahtani MA, Taha A, Yousuf M, Abdullah M (2011) Clinical characteristics of patients with atrial fibrillation at a tertiary care hospital in the central region of Saudi Arabia. J Family Community Med 18:80–84PubMedCentralCrossRefPubMedGoogle Scholar
  3. 3.
    Caglar IM, Dasli T, Turhan Caglar FN, Teber MK, Ugurlucan M, Ozmen G (2012) Evaluation of atrial conduction features with tissue Doppler imaging in patients with chronic obstructive pulmonary disease. Clin Res Cardiol 101:599–606CrossRefPubMedGoogle Scholar
  4. 4.
    Chazan R, Droszcz W (1992) Electrocardiographic changes in patients with airway obstruction. Pol Arch Med Wewn 87:237–241PubMedGoogle Scholar
  5. 5.
    Cui QQ, Zhang W, Wang H, Sun X, Wang R, Yang HY et al (2008) Assessment of atrial electromechanical coupling and influential factors in nonrheumatic paroxysmal atrial fibrillation. Clin Cardiol 31:74–78CrossRefPubMedGoogle Scholar
  6. 6.
    Daubert JC, Pavin D, Jauvert G, Mabo P (2004) Intra- and interatrial conduction delay: implications for cardiac pacing. Pacing Clin Electrophysiol 27:507–525CrossRefPubMedGoogle Scholar
  7. 7.
    Deniz A, Sahiner L, Aytemir K, Kaya B, Kabakci G, Tokgozoglu L et al (2012) Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time. Cardiol J 19:487–493CrossRefPubMedGoogle Scholar
  8. 8.
    Dilaveris PE, Gialafos JE (2001) P-wave dispersion: a novel predictor of paroxysmal atrial fibrillation. Ann Noninvasive Electrocardiol 6:159–165CrossRefPubMedGoogle Scholar
  9. 9.
    Dilaveris PE, Gialafos EJ, Sideris SK, Theopistou AM, Andrikopoulos GK, Kyriakidis M et al (1998) Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 135:733–738CrossRefPubMedGoogle Scholar
  10. 10.
    Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) (2006) Available at: http://www.ginasthma.org/. Accessed 10 Jan 2012
  11. 11.
    Gu J, Liu X, Tan H, Zhou L, Jiang W, Wang Y et al (2013) Impact of chronic obstructive pulmonary disease on procedural outcomes and quality of life in patients with atrial fibrillation undergoing catheter ablation. J Cardiovasc Electrophysiol 24:148–154CrossRefPubMedGoogle Scholar
  12. 12.
    Huerta C, Lanes SF, García Rodríguez LA (2005) Respiratory medications and the risk of cardiac arrhythmias. Epidemiology 16:360–366CrossRefPubMedGoogle Scholar
  13. 13.
    Kallergis EM, Manios EG, Kanoupakis EM, Schiza SE, Mavrakis HE, Klapsinos NK et al (2005) Acute electrophysiologic effects of inhaled salbutamol in humans. Chest 127:2057–2063CrossRefPubMedGoogle Scholar
  14. 14.
    Lai WW, Geva T, Shirali GS, Frommelt PC, Humes RA, Brook MM et al (2006) Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 19:1413–1430CrossRefPubMedGoogle Scholar
  15. 15.
    Melduni RM, Cullen MW (2012) Role of left ventricular diastolic dysfunction in predicting atrial fibrillation recurrence after successful electrical cardioversion. J Atr Fibrillation 5:87–94PubMedCentralPubMedGoogle Scholar
  16. 16.
    Nagarakanti R, Ezekowitz M (2008) Diastolic dysfunction and atrial fibrillation. J Interv Card Electrophysiol 22:111–118CrossRefPubMedGoogle Scholar
  17. 17.
    Okura H, Takada Y, Kubo T, Iwata K, Mizoguchi S, Taguchi H et al (2006) Tissue Doppler-derived index of left ventricular filling pressure, E/E′, predicts survival of patients with non-valvular atrial fibrillation. Heart 92:1248–1252PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
    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. J Am Soc Echocardiogr 18:39–44CrossRefPubMedGoogle Scholar
  19. 19.
    Ozdemir O, Ceylan Y, Razi CH, Ceylan O, Andiran N (2013) Assessment of ventricular functions by tissue Doppler echocardiography in children with asthma. Pediatr Cardiol 34:553–569CrossRefPubMedGoogle Scholar
  20. 20.
    Ozer N, Yavuz B, Can I, Atalar E, Aksöyek S, Ovünç K et al (2005) Doppler tissue evaluation of intra-atrial and interatrial electromechanical delay and comparison with P-wave dispersion in patients with mitral stenosis. J Am Soc Echocardiogr 18:945–948CrossRefPubMedGoogle Scholar
  21. 21.
    Schotten U, Neuberger HR, Allessie MA (2003) The role of atrial dilatation in the domestication of atrial fibrillation. Prog Biophys Mol Biol 82:151–162CrossRefPubMedGoogle Scholar
  22. 22.
    Shedeed SA (2010) Right ventricular function in children with bronchial asthma: a tissue Doppler echocardiographic study. Pediatr Cardiol 31:1008–1015CrossRefPubMedGoogle Scholar
  23. 23.
    Shibata Y, Watanabe T, Osaka D, Abe S, Inoue S, Tokairin Y et al (2011) Impairment of pulmonary function is an independent risk factor for atrial fibrillation: the Takahata study. Int J Med Sci 8:514–522PubMedCentralCrossRefPubMedGoogle Scholar
  24. 24.
    van der Hooft CS, Heeringa J, Brusselle GG, Hofman A, Witteman JC, Kingma JH et al (2006) Corticosteroids and the risk of atrial fibrillation. Arch Intern Med 166:1016–1020CrossRefPubMedGoogle Scholar
  25. 25.
    Warnier MJ, Rutten FH, Kors JA, Lammers JW, de Boer A, Hoes AW et al (2012) Cardiac arrhythmias in adult patients with asthma. J Asthma 49:942–946CrossRefPubMedGoogle Scholar
  26. 26.
    Yücel O, Yildiz M, Altinkaynak S, Sayan A (2009) P-wave dispersion and P-wave duration in children with stable asthma bronchiale. Anadolu Kardiyol Derg 9:118–122PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Murat Çiftel
    • 1
  • Osman Yılmaz
    • 1
  • Fırat Kardelen
    • 2
  • Hasan Kahveci
    • 3
  1. 1.Department of Pediatric CardiologyErzurum Region Training and Research HospitalErzurumTurkey
  2. 2.Department of Pediatric CardiologyAkdeniz University Medical FacultyAntalyaTurkey
  3. 3.Neonatal UnitErzurum Region Training and Research HospitalErzurumTurkey

Personalised recommendations