Assessment of atrial conduction times in prediabetic patients with coronary artery disease

Abstract

Objective: Prediabetes is a dysglycemic state and is associated with subtle myocardial injury and dysfunction. We evaluated atrial conduction times (ACTs) and atrial electromechanical delays (EMDs) in prediabetic patients with coronary artery disease (CAD).

Methods: In the present study, we recruited 128 consecutive patient candidates (40 euglycemic, 48 prediabetic, and 40 diabetic patients) for coronary artery bypass grafting. ACTs were measured using tissue Doppler imaging (TDI). The time intervals between the beginning of the P wave in the surface electrocardiogram and the peak of the a' wave in TDI (PA) in the septal and lateral mitral annuli and the lateral tricuspid annulus were measured and termed as "septal PA," "lateral PA," and "right ventricular (RV) PA," respectively. The differences between lateral and septal PA, septal and RV PA, and lateral and RV PA were termed as "left intra-atrial EMD," "right intra-atrial EMD," and "inter-atrial EMD" respectively.

Results: Septal PA, lateral PA, RV PA, left and right intra-atrial EMDs, and inter-atrial EMD were not statistically different between these three groups. Furthermore, multivariable linear regression models, adjusted for potential confounders, showed that glycemic state was not associated with ACTs, left and right intra-atrial EMDs, and inter-atrial EMD.

Conclusion: There were no significant differences between the euglycemic, prediabetic, and diabetic patients with CAD regarding ACTs and atrial EMDs.

Figure 1

Measurement of atrial conduction times from the beginning of the P wave on the surface electrocardiogram to the peak of the a¢ wave (PA) using tissue Doppler imaging