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    Assessment of p-wave dispersion and atrial electromechanical delay in patients with non-obstructive coronary artery myocardial infarction
    (Springer International Publishing, 2025) Keleşoğlu, Şaban; Yılmaz, Yücel; Elçik, Deniz; İnci, Sinan; Gül, Murat; Kalay, Nihat
    We investigated p-wave dispersion (Pd) and atrial electromechanical delay (EMD) in patients diagnosed with non-obstructive coronary artery disease and myocardial infarction (MINOCA). Background: The clinical importance and recognition of MINOCA are increasing. However, there is a gap in knowledge regarding the risk of atrial fibrillation in patients with MINOCA. Methods: Forty-three patients with MINOCA (average age 48.69 ± 5.83 years) and thirty-four patients with non-obstructed coronary artery disease (INOCA) (average age 49.82 ± 10.22 years) were enrolled in the study. Echocardiographic studies were conducted in the MINOCA and INOCA groups in the left lateral decubitus position using a medical ultrasound device. Atrial electromechanical coupling (PA) and intra-atrial and interatrial EMD were measured using tissue Doppler echocardiography. Pd was measured using 12-lead electrocardiography. Results: Clinical and demographic characteristics were similar between groups. The maximum P-wave (Pmax) time and Pd values of patients diagnosed with MINOCA were significantly longer than those of patients diagnosed with INOCA (Pmax times: 109.72 ± 7.09 ms and 95.17 ± 7.50 ms, respectively, p < 0.01; Pd: 47.30 ± 8.99 ms and 34.14 ± 11.31 ms, respectively, p < 0.01). Tissue Doppler Imaging (TDI) revealed significantly longer atrial EMD parameters (PA lateral and PA septum) in patients diagnosed with MINOCA than in those diagnosed with INOCA (69.60 ± 8.79 ms and 57.08 ± 11.54 ms, respectively, p < 0.01; 54.83 ± 6.45 ms and 45.35 ± 8.50 ms, respectively, p < 0.01). Conclusion: This study showed that the duration of atrial EMD and Pd was prolonged in patients with MINOCA, suggesting a potential susceptibility to atrial conduction abnormalities.
  • Küçük Resim
    Öğe
    Identification of subclinical myocardial dysfunction by Speckle Tracking Imaging in patients with myocardial infarction with non-occlusive coronary arteries (MINOCA)
    (Springer, 2022) İnci, Sinan; Gül, Murat; Elçik, Deniz; Aktaş, Halil; Yıldırım, Oğuz; Keleşoğlu, Saban; Kalay, Nihat
    Purpose The objective of this study was to investigate subclinical left ventricular dysfunction in patients diagnosed with myocardial infarction with non-occlusive coronary arteries (MINOCA). Methods Thirty-five patients with MINOCA (average age 54.26 +/- 12.24 years) and thirty-five patients with ischemia with non-obstructed coronary artery disease (INOCA) (average age 55.20 +/- 8.36 years) were enrolled in the study. All clinical conditions that could affect left ventricular functions were considered exclusion criteria. Echocardiographic studies were conducted in the patient and control groups in the left lateral decubitus position using a medical ultrasound device (EPIQ 7, Philips Medical System, USA). The left ventricle was examined longitudinally with apical images of chamber 4-3-2 using the available software (QLAB 6.0). Results There were no differences in age, blood pressure level, baseline echocardiogram measurements, and tissue Doppler parameters between the two groups. In two-dimensional speckle tracking echocardiography (2D-STE) measurements, left ventricular longitudinal strain and strain rate in systole, early and late diastole from apical 4-3-2 chamber and global measurements of each parameter were significantly decreased in the MINOCA group compared to the INOCA group (p < 0.05). A significant negative correlation was observed between the global longitudinal strain rate and the troponin I in the MINOCA patients group (r=-0.43 p = 0.009). Conclusions Our study showed that while standard echocardiographic parameters for patients diagnosed with MINOCA were normal, their left ventricular systolic and diastolic functions were reduced by the 2D-STE method.