Atrial Electromechanical Properties in Inflammatory Bowel Disease

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 33; no. 9; pp. 1309 - 1316
• Main Authors: Efe, Tolga Han, Cimen, Tolga, Ertem, Ahmet Goktug, Coskun, Yusuf, Bilgin, Murat, Sahan, Haluk Furkan, Pamukcu, Hilal Erken, Yayla, Cagri, Sunman, Hamza, Yuksel, Ilhami, Yeter, Ekrem
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.09.2016
• Subjects: Adult; atrial fibrillation; Atrial Fibrillation - physiopathology; Crohn's disease; Echocardiography - methods; electromechanical delay; Excitation Contraction Coupling; Female; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Heart Conduction System - physiopathology; Humans; inflammatory bowel disease; Inflammatory Bowel Diseases - physiopathology; Male; Myocardial Contraction; Reproducibility of Results; Sensitivity and Specificity; ulcerative colitis; atrial fibrillation; Crohn's disease; ulcerative colitis; electromechanical delay; inflammatory bowel disease
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.13261

Background There is much evidence linking inflammation to the initiation and continuation of atrial fibrillation (AF). Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic systemic inflammatory disorders. Atrial electromechanical delay (EMD) has been known as an early marker of AF. The objectives of this study were to evaluate the atrial electromechanical properties in patients with IBD. Methods Fifty‐two patients with IBD and 26 healthy controls were recruited in the study. Twenty‐five of patients with IBD were on active period, and the remaining 27 were on remission period. Atrial electromechanical properties were measured by using transthoracic echocardiography and tissue Doppler imaging and simultaneous surface ECG recording. Interatrial EMD, left intraatrial EMD, and right intraatrial EMD were calculated. Results Patients on activation with IBD had significantly prolonged left and right intraatrial EMDs and interatrial EMD compared to patients on remission (P = 0.048, P = 0.036, P < 0.001, respectively) and healthy controls (P < 0.001, for all comparisons). Left and right intraatrial EMDs and interatrial EMD were also found to be higher when patients on remission with IBD compared with healthy controls. No statistical difference was observed between UC and CD in terms of inter‐ and intraatrial EMDs. Conclusions Atrial electromechanical conduction is prolonged in IBD, and exposure to chronic inflammation may lead to structural and electrophysiological changes in the atrial tissue that causes slow conduction. Measurement of atrial EMD parameters might be used to predict the risk for the development of AF in patients with IBD.