Related Experiment Video
Updated: Jul 17, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Assessment of atrial conduction in patients with scleroderma by tissue Doppler echocardiography and P wave dispersion
Ilknur Can1, Ahmet Mesut Onat, Kudret Aytemir
1Department of Cardiology, Hacettepe University, Ankara, Turkey. ilknur1973@gmail.com
Insights
Patients with scleroderma exhibit significant atrial conduction abnormalities, including prolonged P wave duration and dispersion. Electromechanical coupling is also delayed, indicating impaired atrial function in this population.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Atrial conduction abnormalities in scleroderma patients remain understudied.
- Previous research has not evaluated P wave duration, P wave dispersion (P(d)), or electromechanical coupling using tissue Doppler echocardiography in this cohort.
Purpose of the Study:
- To investigate atrial conduction abnormalities in scleroderma patients.
- To assess P wave duration, P wave dispersion (P(d)), and interatrial/intraatrial electromechanical coupling using electrocardiogram (ECG) and tissue Doppler echocardiography.
Main Methods:
- Twenty-four scleroderma patients and 24 controls underwent resting ECG and M-mode/tissue Doppler echocardiography.
- P wave duration and dispersion (P(d)) were calculated from surface ECG leads.
- Interatrial and intraatrial electromechanical delays were measured using tissue Doppler echocardiography.
Main Results:
- Scleroderma patients showed significantly higher P wave duration (P(max)) and P wave dispersion (P(d)) compared to controls.
- Delayed intraatrial and interatrial electromechanical coupling intervals were observed in scleroderma patients.
- A positive correlation was found between interatrial electromechanical delay and P(d).
Conclusions:
- Patients with scleroderma demonstrate significant atrial conduction abnormalities, evidenced by increased P wave duration and dispersion.
- There are notable delays in both intraatrial and interatrial electromechanical coupling in scleroderma patients.
- These findings suggest impaired atrial electrical and mechanical function in scleroderma.
Background:
Atrial conduction abnormalities in patients with scleroderma have not been evaluated in terms of P wave duration, P wave dispersion (P(d)) and electromechanical coupling measured by tissue Doppler echocardiography.
Methods:
Twenty-four patients with scleroderma and 24 control subjects underwent resting electrocardiogram (ECG), M mode and tissue Doppler echocardiography. The P wave duration was calculated in all leads of the surface ECG. The difference between the maximum (P(max)) and minimum P wave duration was calculated and defined as P(d). Interatrial and intraatrial electromechanical delays were measured with tissue Doppler tissue echocardiography.
Results:
The left ventricular dimensions, fractional shortening, and left atrial diameter did not differ between the patients and the controls. P(d) and P(max) were significantly higher in patients with scleroderma compared with controls: 51 +/- 17 versus 28 +/- 7 ms (p < 0.01) and 109 +/- 10 versus 93 +/- 6 ms (p < 0.01), respectively. There was a delay between the onset of the P wave on surface ECG and the onset of the late diastolic wave (A wave; PA) obtained by tissue Doppler echocardiography in patients with scleroderma compared with controls measured at lateral septal annulus (lateral PA; 122 +/- 8 vs. 105 +/- 7 ms, p = 0.001), septal mitral annulus (104 +/- 11 vs. 93 +/- 10 ms, p = 0.01) and tricuspid annulus (right ventricular PA; 71 +/- 9 vs. 64 +/- 7 ms, p = 0.05). Interatrial conduction time (lateral PA - right ventricular PA) was delayed in patients with scleroderma compared with controls (88 +/- 13 vs. 76 +/- 11 ms, p = 0.01). A positive correlation was detected between interatrial electromechanical delay (lateral PA - right ventricular PA) and P(d) (r = 0.5, p = 0.03).
Conclusion:
Atrial conduction abnormalities as estimated with P(d) and P(max) are significantly higher in patients with scleroderma compared with controls. There is a delay in both intraatrial and interatrial electromechanical coupling intervals in patients with scleroderma.
Related Concept Videos
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:30Dysrhythmias V: Evaluating Dysrhythmias