The relationship between epicardial adipose tissue and P wave and QT dispersions

Abstract

Amaç: Epikardiyal adipoz doku (EAD) kalpte pek çok endok- rin ve parakrin etkiye sahip olan çeşitli enflamatuvar ve atero- jenik ajanları salgılar. Bu çalışmada, EAD’nin elektrokardiyo- gafinin (EKG) basit, non-invaziv aritmi belirteçleri olan QT ve P dalga dispersiyonu (QTd, PDd) üzerine etkisini araştırmayı planladık. Yöntemler: Kesitsel yapıda çalışmamıza koroner arterle- ri normal 70 hasta alındı. Bu hastalara 12 derivasyon EKG, ekokardiyografi, biyokimyasal çalışmalar yapılarak, QTd, PDd ve EAD kalınlığı hesaplandı. Bulgular: Ortanca EAD 4.1 mm olarak bulundu. EAD yaş (r=0.412, p<0.001), vücut ağırlığı (r=0.262, p=0.028), beden kitle indeksi (r=0.396, p<0.001), sol atriyum boyutu (r=0.518, p<0.001), açlık plazma glukozu (r=0.245, p=0.041), maksi- mum P dalga süresi (r=0.343, p=0.004), minimum P dalga süresi (r=0.275, p=0.021) ve PDd (r=0.265, p=0.026) ile ko- releydi. QTd ile çalışılan parametreler arasında ilişki saptan- madı. Ancak PDd; EAD kalınlığı (r=0.265, p=0.026), sol atri- yum boyutu (r=0.483, p<0.001) ve trigliserit düzeyi (r=0.267, p=0.028) ile ilişkiliydi. Çok değişkenli analiz sol atriyum bo- yutunun PDd’nin tek bağımsız belirleyicisi olduğunu ortaya koydu. Sonuç: Çalışmamızda EAD ile PDd arasında anlamlı bir ilişki saptadık. Her ne kadar EAD hem PDd ve hem de sol atriyum boyutu ile ilişkili ise de, sol atriyum boyutu, koroner arterle- ri normal hastalarda atriyum fibrilasyonu riski için EAD’den daha önemli gibi görülmektedir.

Objective: Epicardial adipose tissue (EAT) secretes various pro- inflammatory and atherogenic mediators that have several en- docrine and paracrine effects on heart. This study investigated the influence of EAT on QT and P wave dispersions (QTd, PWd), as simple, non-invasive tools of proarrhythmia on surface ECG. Methods: This was a cross-sectional study and included 70 patients with normal coronary arteries who underwent 12-derivation electrocardiography, echocardiography and bio- chemical examinations in order for QTd, PWd, and EAT thick- ness to be measured. Results: Median EAT thickness was 4.1 mm. Correlation analyses revealed that EAT was significantly associated with age (r=0.412, p<0.001), weight (r=0.262, p=0.028), body mass index (r=0.396, p<0.001), left atrium diameter (r=0.518, p<0.001), fasting plasma glucose (r=0.245, p=0.041), maxi- mum P wave duration (r=0.343, p=0.004), minimum P wave du- ration (r=0.275, p=0.021) and PWd (r=0.265, p=0.026). No rela- tion was found between study parameters and QTd. However, P wave dispersion was significantly related to EAT thickness (r=0.265, p=0.026), left atrium diameter (r=0.483, p<0.001), and the triglyceride levels (r=0.267, p=0.028). Multiple linear regression analyses revealed left atrial diameter as the only in- dependent predictor of PWd. Conclusion: A significant association between EAT and PWd was demonstrated in the study. While EAT is related to both increased PWd and left atrial size, left atrial diameter seems to be more important than EAT for prediction of atrial fibrilla- tion (AF) in patients with normal coronary arteries.