Delayed right atrial lateral electromechanical coupling relative to the septal one can be associated with paroxysmal atrial fibrillation.

BACKGROUND: Non-invasive prediction of paroxysmal atrial fibrillation (PAF) is one of the most recent interests of cardiology. AIM: The current study investigates the relationship between the atrial electromechanical coupling time (EMCT) and PAF. PATIENTS AND METHODS: A group of 35 patients with PAF was compared with a group of 37 subjects without PAF. Pulsed wave tissue Doppler evaluations of atrial walls were performed from apical four chambers view under ECG monitoring. The time intervals from the onset of P wave to the onset of late diastolic wave (A') at right atrial wall (P-RA), interatrial septum (P-IAS), and left atrial wall (P-LA, maximum EMCT) were measured. The right atrial EMCT (P-RA minus P-IAS), left atrial EMCT (P-LA minus P-IAS) and interatrial EMCT (P-LA minus P-RA) were computed. A' wave velocities were measured from each atrial wall. RESULTS: RA (16.0±13.1 vs. -8.7±18.6 ms, p < 0.001) and maximum (91.5±32.6 vs. 72.0±23.1 ms, p = 0.001) EMCT were longer, RA A' velocity was higher in the patient group. There were no differences between the groups in LA and interatrial EMCT, and septal and LA A' velocities. Regression analysis revealed that only RA [OR: 1.148 (1.041-1.267), p = 0.006] and maximum [OR: 1.099 (1.009-1.197), p = 0.031] EMCT were independent variables for PAF. In order to predict patients with PAF, we have chosen +7.5 msn for the RA EMCT which yielded 69% sensitivity and 71.4% specificity to predict patients. CONCLUSIONS: Delayed RA lateral EMCT relative to septal one and delayed maximum EMCT detected by tissue Doppler could be a valuable method for identifying patients with PAF.

Aortic elastic properties in patients with venous thromboembolism.

OBJECTIVES: The relationship between venous thrombosis (VT) and atherosclerosis is controversial in recent studies. Aortic elastic properties have a predictive value in detecting early stages of atherosclerosis. The aim of this study is to evaluate the relationship between aortic elastic properties and VT. METHODS: Elastic properties of aorta in patients with spontaneous VT, without history of known cardiovascular disease and cardiovascular risk factors (n: 31), and in healthy subjects without cardiovascular risk factors (n: 30) were compared. Elastic properties of the aorta were assessed with transthoracic echocardiography. RESULTS: A significant increase in aortic stiffness index (6.5 ± 1.0 versus 6 ± 0.7, P = 0.03) and a significant decrease in aortic strain and aortic distensibility were found in patients with VT compared with healthy subjects (8.4 ± 7 versus 13 ± 8, P = 0.01, 4.9 ± 4.8 versus 6.5 ± 4.4, P = 0.03, respectively). CONCLUSIONS: Elastic properties of aorta in patients with spontaneous VT were impaired. These results may support the role of endothelial dysfunction in the pathogenesis of VT.

Elastic properties of aorta in patients with primary hyperparathyroidism.

In this study, we aimed to evaluate whether hyperpara thyroidism affects the elastic properties of aorta, calculated as aortic distensibility and aortic stiffness index. Eighteen patients with hyperparathyroidism were enrolled in the study. The control group consisted of 18 healthy subjects with similar baseline characteristics. All subjects underwent echocardiographic examination. Internal aortic root diameters were measured at 3 cm above the aortic valve by the use of two-dimensional guided M-mode transthoracic echocardiography, and arterial blood pressure was measured simultaneously from the brachial artery by sphygmomano metry. Two indexes of the aortic elastic properties were measured which are aortic distensibility and aortic stiffness index. The mean aortic stiffness index of hyperparathyroidic patients was higher (3.04 +/- 1.26 vs. 2.36 +/- 1.09; p = 0.048), and aortic distensibility was lower (15.62 +/- 5.84 vs. 22.64 +/- 14.54; p = 0.035) than the control group. The left ventricular (LV) mass index (242.44 +/- 46.3 vs. 212.8 +/- 43.97; p = 0.048), although it has failed to reach statistical significance, and LV wall stress (57.81 +/- 18.22 vs. 46.57 +/- 15.72; p = 0.08) of these patients was also higher than control group. Hyperparathyroidism increases aortic stiffness index and decreases aortic distensibility of primary hyper parathyroidic patients compared with normal population. The affected aortic elastic properties can be a factor in increased LV mass index and wall stress.