Effect of reperfusion P-wave duration and P-wave dispersion in acute myocardial infarction: Primary angioplasty versus thrombolytic therapy
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Dosyalar
Tarih
2004
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Atriyal fibrilasyon akut miyokard enfarktüslü hastalarda %10-20 sıklıkla görülen bir aritmidir. P dalga süreleri ve dispersiyonu sinus noddan çıkan uyarının atriyal yayılımının bozulmasını incelemede kullanılmaktadır. Bu çalışma akut ön duvar miyokard enfarktüsü geçirmiş hastalarda primer anjioplasti ve trombolitik tedavinin P dalga süre ve dispersiyonuna etkisini araştırmaktadır. Akut ön duvar miyokard enfarktüsü geçiren 24 kadın, 48 erkek toplam 72 hasta çalışmaya alındı. Hastalar primer anjioplasti ve trombolitik tedavi almak üzere randomize edildi. Klinik, ekokardiyografik ve EKG değerleri incelendi. Tedavi öncesi ve sonrası P dalga süreleri ve dispersiyonu karşılaştırıldı. Yaş, cinsiyet, sol ventrikül ejeksiyon fraksiyonu, sol atriyum çapları ve kardiyovasküler risk faktörleri açısından karşılaştırıldıklarında her iki grupta anlamlı istatistiksel farklılık bulunmadı. Primer anjioplasti grubunda tedaviden sonar P dalga süreleri ve dispersiyonu anlamlı olarak azalmış ve her iki grup karşılaştırıldığında p max ve dispersiyon azalması anjioplasti grubunda istatistiksel olarak daha fazla saptandı. Primer anjioplasti, P dalga süreleri ve dispersiyonunu trombolitik tedaviye göre anlamlı olarak azaltır.
Atrial fibrillation is a common arrhythmia occurring in about 10-20% of patients with acute myocardial infarction. P-wave dispersion and P-wave duration have been used to evaluate the discontinuous propagation of sinus impulse and the prolongation of atrial conduction time respectively. This study was conducted to compare the effects of reperfusion either by thrombolytic therapy or primary angioplasty on P wave duration and dispersion in patients with acute anterior wall myocardial infarction. We have retrospectively evaluated 72 consecutive patients (24 women, 48 men; aged 58±12 years) experiencing a first acute anterior wall myocardial infarction (AMI). Patients were grouped according to the reperfusion therapy received (primary angioplasty (PTCA) versus thrombolytic therapy). Left atrial diameter and left ventricular ejection fraction (LVEF) were determined by echocardiography in all patients. Electrocardiography was recorded from all patients on admission and on pach day of hospitalization. Maximum (P max) and minimum (P min) P wave durations and P wave dispersions (PWd) were calculated before and after treatment. There were no significant differences between the groups regarding age, gender, left ventricular ejection fraction (LVEF), left atrial diameter and volume, cardiovascular risk factors and duration from symptom onset to treatment. PWd and P wave durations were significantly reduced after PTCA (mean P max was 1 13±11 ms before and 95±17ms after the treatment [p=0.007]. Mean PWd was 46±12 ms before and 29±10 ms after the treatment (p=0.001). Also, P max and PWd were significantly lower in PTCA group (for P max 97±22 ms versus 114±16 ms and for PWd 31±13 ms versus 55±5 ms, respectively). Primary angioplasty reduces P max and P wave dispersion.
Atrial fibrillation is a common arrhythmia occurring in about 10-20% of patients with acute myocardial infarction. P-wave dispersion and P-wave duration have been used to evaluate the discontinuous propagation of sinus impulse and the prolongation of atrial conduction time respectively. This study was conducted to compare the effects of reperfusion either by thrombolytic therapy or primary angioplasty on P wave duration and dispersion in patients with acute anterior wall myocardial infarction. We have retrospectively evaluated 72 consecutive patients (24 women, 48 men; aged 58±12 years) experiencing a first acute anterior wall myocardial infarction (AMI). Patients were grouped according to the reperfusion therapy received (primary angioplasty (PTCA) versus thrombolytic therapy). Left atrial diameter and left ventricular ejection fraction (LVEF) were determined by echocardiography in all patients. Electrocardiography was recorded from all patients on admission and on pach day of hospitalization. Maximum (P max) and minimum (P min) P wave durations and P wave dispersions (PWd) were calculated before and after treatment. There were no significant differences between the groups regarding age, gender, left ventricular ejection fraction (LVEF), left atrial diameter and volume, cardiovascular risk factors and duration from symptom onset to treatment. PWd and P wave durations were significantly reduced after PTCA (mean P max was 1 13±11 ms before and 95±17ms after the treatment [p=0.007]. Mean PWd was 46±12 ms before and 29±10 ms after the treatment (p=0.001). Also, P max and PWd were significantly lower in PTCA group (for P max 97±22 ms versus 114±16 ms and for PWd 31±13 ms versus 55±5 ms, respectively). Primary angioplasty reduces P max and P wave dispersion.
Açıklama
Anahtar Kelimeler
Primarp Angioplasty, P Wave Duration, P Wave Dispersion, Primer Anjiyoplasti, P Dalga Süresi, P Dalga Dispersiyonu
Kaynak
Türk Kardiyoloji Derneği Arşivi
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
32
Sayı
5