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P Wave Analysis in Patients with Sarcoidosis

International Journal of Clinical Medicine 2013年第9期4卷 388-394页

作者： elias Gialafos elias perros Aggeliki Rapti Theodore G. Papaioannou Vassilios Kouranos Ioannis Moyssakis Konstantina Aggeli Georgios Dimopoulos Charalambos Kostopoulos Eleftherios Stamboulis John Gialafos Christodoulos Stefanadis Nikolaos Koulouris Myron Mavrikakis Department of Cardiology University of Athens Athens Greece Department of Clinical Therapeutics University of Athens Athens Greece Department of Clinical Therapeutics University of Athens Athens Greece Department of Criti- cal Care Medicine University of Athens Athens Greece. Department of Neurology University of Athens Athens Greece Department of Neurology University of Athens Athens Greece Department of Pulmonology University of Athens Athens Greece Department of Pulmonology University of Athens Athens Greece Outpatient Department of Sarcoidosis Chest Disease Hospital “Sotiria” Athens Greece

Introduction: Atrial arrhythmias in patients with sarcoidosis (Sar) are not unusual and can occur due to either atrial myocardial fibrosis and/or due to autonomic nervous system imbalance. Electrocardiographic markers (ECG), like maximum and minimum P wave duration and P wave dispersion {Pdis = Pmax?﹣Pmin} reflect atrial depolarization inhomogeneity and can indicate patients prone to develop atrial arrhythmias while standard deviation of RR interval (SDNN) is an index of heart rate variability, reflecting autonomic nervous system (ANS) activity. Methods: 90 patients with sarcoidosis (41 males/49 females) enrolled in this multicenter prospective study underwent digital electrocardiography, echocardiography and pulmonary function tests (PFTs). Diastolic and systolic indices of right and left ventricle were measured echocardiographically including Doppler parameters while Pmax, Pmin, Pdis and SDNN were measured in a 5-minute duration digital electrocardiogram. All consecutive patients were compared to 65 healthy volunteers (30 males/35 females). Results: Although heart rate and the echocardiographic indices were similar among the two groups, the electrocardiographic indices were significantly prolonged in the patient group compared to controls. Maximum P wave duration was correlated with SDNN (p dis was correlated with SDNN (p max and Pdis were independently correlated with SDNN. Conclusion: P wave dispersion is significantly increased in patients with systemic sarcoidosis compared to healthy persons while maximum P wave duration and P wave dispersion are negatively correlated with the standard deviation of RR, an index of heart rate variability implying imbalance of ANS function. Further studies are needed for the clarification of the significance of this correlation.

关键词： P Wave Analysis Systemic Sarcoidosis Autonomic Nervous System

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