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January 1, 2007Circulation Journal68 citationsOpen Access

The Effect of Diabetes Mellitus on the P-Wave Dispersion

MYMehmet YazıcıKÖKurtuluş ÖzdemirBABülent B. Altunkeser

Key Result

Diabetes mellitus significantly increased P-wave dispersion compared to healthy controls (33 ms vs 28 ms, p=0.02) even in the absence of ischemia, hypertension, and left ventricular hypertrophy.

Study Design

Type

Cross-Sectional (n=116)

Blinding

Single-blind

Multicenter

No

Structured PICO

Does diabetes mellitus increase P-wave dispersion in patients without coronary artery disease and hypertension?

P
Population
116 adults (mean age ~47, 55% female), comprising 76 uncomplicated diabetic patients and 40 healthy controls, assessed for P-wave dispersion.
E
Exposure
Diabetes Mellitus (80% Type II, mean duration 5.6 years; 33% receiving insulin, 67% receiving oral anti-diabetic treatment)
C
Comparator
Healthy volunteer individuals without diabetes, coronary artery disease, or hypertension
O
Outcome
P-wave dispersion (PD), defined as the difference between maximum (P max) and minimum (P min) P-wave durations on standard 12-lead ECGsurrogate

Diabetes mellitus is associated with increased P-wave dispersion, a marker of atrial refractoriness heterogeneity and potential atrial fibrillation risk, even in the absence of ischemia, hypertension, and left ventricular hypertrophy.

Main Result

Absolute Event Rate: 33% vs 28%

p-value: p=0.02

Limitations

  • Coronary artery disease was excluded using clinical symptoms and resting/stress ECG rather than coronary angiography or myocardial stress imaging.
  • Diabetic patients were slightly older and had slightly higher blood pressure than controls, though differences were not statistically significant.
  • Small sample size requiring larger population studies to clarify effects.
  • Coronary artery disease was excluded based on absence of anginal symptoms and ischemic ECG changes during stress testing rather than coronary angiography or myocardial stress imaging
  • Diabetic patients were slightly older (2 years) with slightly higher blood pressure than controls, though differences were not statistically significant

Abstract

BACKGROUND: P-wave dispersion (PD), a measure of heterogeneity of atrial refractoriness, is defined as the difference between the minimum (P min) and maximum P-wave (P max) durations on standard 12-lead electrocardiography (ECG). Increase in PD shows the intra-atrial and inter-atrial non-uniform conduction. In the present study the evaluation of the effect of diabetes mellitus (DM) on PD in patients without coronary artery disease and hypertension was carried out. METHODS AND RESULTS: Seventy-six diabetic patients who had no coronary artery disease or hypertension (group 1; mean age 48+/-9) and 40 healthy volunteer individuals (group 2; mean age 46+/-13) were enrolled in the study. After obtaining 12-lead surface ECG of all cases, P max and P min P-wave durations were measured and the differences between them were taken as PD (PD=P max-P min). Left atrium diameter, left ventricular end systolic and end diastolic diameters were measured and left ventricular ejection fraction was determined by echocardiography. Pulse wave mitral flow velocities were measured from the apical 4-chamber view. Mitral early diastolic velocity (E), late diastolic velocity (A), E/A, E deceleration time and isovolumetric relaxation time were determined. In comparison of the 2 groups there was no statistically significant difference among age, sex, systolic and diastolic blood pressure, resting heart rate and body mass index of the cases. Although PD and P max were significantly higher in diabetic patients, there was no difference between P min values (33+/-12 vs 28+/-10, p=0.02; 99+/-12 vs 93+/-10, p=0.011; 66+/-9 vs 65+/-10, p=NS; respectively). CONCLUSIONS: DM might increase PD even without ischemia, hypertension and left ventricular hypertrophy.

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Cite This Study

Yazıcı et al. (2007) conducted a cross-sectional in Diabetes Mellitus (n=116). Diabetes Mellitus vs. Healthy volunteers was evaluated on P-wave dispersion (PD) (p=0.02). Diabetes mellitus significantly increased P-wave dispersion compared to healthy controls (33 ms vs 28 ms, p=0.02) even in the absence of ischemia, hypertension, and left ventricular hypertrophy.

synapsesocial.com/papers/6a20596567e003a2985ad7a7https://doi.org/10.1253/circj.71.880
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Also Consider

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