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Determinants of left intra‐atrial electromechanical delay as evaluated by tissue Doppler imaging in candidates for coronary artery bypass graft surgery
Author(s) -
Etemad Taimoor,
Hosseinsabet Ali
Publication year - 2020
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14599
Subject(s) - medicine , cardiology , atrial fibrillation , odds ratio , diuretic , diabetes mellitus , univariate analysis , doppler imaging , coronary artery bypass surgery , artery , multivariate analysis , diastole , endocrinology , blood pressure
Objectives Inhomogeneity in the atrial conduction time is a predisposing factor for atrial fibrillation. The aim of our study was to determine the independent determinants of the left intra‐atrial electromechanical delay (LIAEMD) as a marker of left atrial (LA) dyssynchrony in candidates for coronary artery bypass graft surgery (CABGS). Methods This prospective cross‐sectional study recruited 516 consecutive candidates for CABGS. Via the pulsed‐wave tissue Doppler imaging modality in echocardiography, the times between the P wave and the peak of the a′ wave at the septal and lateral mitral annuli were measured and the difference between these times was considered to be LIAEMD. Additionally, clinical and laboratory data on each patient were gathered. The odds ratio for an increased LIAEMD was calculated in patients with and without diabetes in univariate and multivariate analyses. Results The multivariable analysis revealed that in the patients without diabetes, obesity, calcium‐channel blocker usage, an increased maximal LA volume, and a decreased lateral e′/a′ ratio and in the diabetic patients, diuretic usage and a decreased lateral e′/a′ ratio were independently correlated with an increased likelihood of LIAEMD occurrence ( P < .05). Conclusions In our study on CABGS candidates, in the patients without diabetes, obesity, an increased maximal LA volume, calcium‐channel blocker usage, and a decreased lateral e′/a′ ratio and in the diabetic patients, diuretic usage and a decreased lateral e′/a′ ratio independently determined increased LIAEMD. The prevention or treatment of factors that are detrimental to the LA electromechanical function may be helpful for the preservation of the LA electromechanical integrity.