Increased P wave dispersion in hypothyroidism: a sign of risk of atrial fibrillation

Aim: As in hyperthyroidism, cardiac arrhythmias can be seen in hypothyroidism. In this study, we measured P wave dispersion among hypothyroid patients to evaluate atrial fibrillation risk. Methods: 75 patients who received first time diagnosis of hypothyroidism and 40 normal control patients were included in this study. Each patient had echocardiographic and electrocardiographic studies were carried out. Groups were compared for statistically significant difference in P wave dispersion, minimum P wave duration and maximum P wave duration. Results: The groups were similar in echocardiographic and electrocardiograpic features. P wave dispersion was significantly higher in the hypothyroid group compared to normal controls (31.9±9.3 ms vs. 26.5±9.4 ms, P = 0.003). Minimum P wave duration was significantly shorter in the hypothyroid group compared to controls (63.8±9.2 ms vs 68 ± 9.2ms, P = 0.026). Maximum P wave duration was not significantly different between groups (95.4±12.3 ms vs. 94.7±8.7 ms, p.0, 74). Conclusion: P wave dispersion was increased in the first time diagnosed clinical hypothyroid patients. This is the first study to evaluate P wave dispersion in clinical hypothyroid patients. We believe that our findings have clinically important implications and provide insight into possible mechanisms of this morbid condition.

Increased P wave dispersion in hypothyroidism: a sign of risk of atrial fibrillation

Aim: As in hyperthyroidism, cardiac arrhythmias can be seen in hypothyroidism. In this study, we measured P wave dispersion among hypothyroid patients to evaluate atrial fibrillation risk. Methods: 75 patients who received first time diagnosis of hypothyroidism and 40 normal control patients were included in this study. Each patient had echocardiographic and electrocardiographic studies were carried out. Groups were compared for statistically significant difference in P wave dispersion, minimum P wave duration and maximum P wave duration. Results: The groups were similar in echocardiographic and electrocardiograpic features. P wave dispersion was significantly higher in the hypothyroid group compared to normal controls (31.9±9.3 ms vs. 26.5±9.4 ms, P = 0.003). Minimum P wave duration was significantly shorter in the hypothyroid group compared to controls (63.8±9.2 ms vs 68 ± 9.2ms, P = 0.026). Maximum P wave duration was not significantly different between groups (95.4±12.3 ms vs. 94.7±8.7 ms, p.0, 74). Conclusion: P wave dispersion was increased in the first time diagnosed clinical hypothyroid patients. This is the first study to evaluate P wave dispersion in clinical hypothyroid patients. We believe that our findings have clinically important implications and provide insight into possible mechanisms of this morbid condition.

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  • Szabó Z, Kakuk G, Fülöp T, Mátyus J, Balla J, Kárpáti I, et.al. Effects of haemodialysis on maximum P wave duration and P wave dispersion. Nephrol Dial Transplant. 2002; 17(9): 1634-8.
  • Tsikouris JP, Kluger J, Song J, White CM.Changes in P wave dispersion and P wave duration after open heart surgery associated with the peak incidence of AF. Heart Lung. 2001; 30(6): 466-71.
  • Tükek T, Yildiz P, Akkaya V, Karan MA, Atilgan D, Yilmaz V, et.al. Factors associated with the development of AF in COPD patients: the role of P wave dispersion. Ann Noninvasive Electrocardiol. 2002; 7(3): 222-7.
  • Ho TF, Chia EL, Yip WC, Chan KY. Analysis of P wave and P dispersion in children with secundum ASD. Ann Noninvasive Electrocardiol. 2001; 6(4): 305-9.
  • Cui G, Kobashigawa J, Chung T, Sen L. Atrial conduction disturbance as an indicator of rejection after cardiac transplantation. Transplantation 2000 15; 70(1): 223-7.
  • Aras D, Maden O, Ozdemir O, Aras S, Topaloglu S, Yetkin E, et. al: Simple electrocardiographic markers for the prediction of paroxysmal atrial fibrillation in hyperthyroidism. Int J Cardiol. 2005 10; 99(1): 59-64.
  • Li D, Fareh S, Leung TK, Nattel S. Promotion of atrial fibrillation by heart failure in dogs: atrial remodeling of a different sort. Circulation 1999 6; 100(1): 87-95.
  • Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ, et.al. Pathophysiology and Prevention of Atrial Fibrillation. Circulation. 2001 6; 103(5): 769-77. 18. Tagata M, Nagao M, Suzuki Y, Iida H, Kageyama F, et. al. A case of myxedema heart with serial endomyocardial biopsy. Kokyu To Junkan. 1992; 40(10): 1019-23 Fujimoto K,
  • Okabe M, Kubara K, Kawaguchi H, Kawano T, Nakashima Y, Fukuda K, et. al. A case of myxedema with diffuse myocardial fibrosis proven by endomyocardial biopsy. Kokyu To Junkan. 1990; 38(11): 1159-63.
  • McNearney TA, Reveille JD, Fischbach M, Friedman AW, Lisse JR, Goel N, et.al. Pulmonary Involvement in Systemic Sclerosis:Associations With Genetic, Serologic, Sociodemographic, and Behavioral Factors. Arthritis Rheum 2007 15; 57(2): 318-26.
  • Ono N, Hayashi H, Kawase A, Lin SF, Li H, Weiss JN, et. al. Spontaneous atrial fibrillation initiated by triggered activity near the pulmonary veins in aged rats subjected to glycolytic inhibition Am J Physiol Heart Circ Physiol. 2007; 292(1): H639- 48.
  • Giordano C, Stassi G, De Maria R, Todaro M, Richiusa P, Papoff G, et.al. Potential involvement of Fas and its ligand in the pathogenesis of Hashimoto's thyroiditis. Science. 1997, 14; 275(5302): 960-3.
  • Gunduz H, Binak E, Arinc H, Akdemir R, Ozhan H, Tamer A, et.al.The Relationship between P Wave Dispersion and Diastolic Dysfunction. Tex Heart Inst J 2005; 32: 163-7.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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