Assessment of atrial conduction time and P wave dispersion in patient with gestational diabetes mellitus

Aim: Gestational Diabetes Mellitus (GDM) is a glucose tolerance disorder at any level that starts with pregnancy or is noticed during pregnancy. The risk of developing type 2 diabetes mellitus (DM) and cardiovascular disease has increased in women with GDM during long-term follow-up. DM patients are at high risk for atrial fibrillation, and a significant proportion of patients with atrial fibrillation are diabetic. It is known that prolonged P wave dispersion and electromechanical delay times obtained by tissue Doppler echocardiography are noninvasive predictors of atrial fibrillation development. It is also known that it can predict the development of atrial fibrillation. In our study we aimed to asses atrial conduction time and P wave dispersion in GDM patients. Materials and Methods: 30 patients with GDM and 30 healthy pregnant women were included in the study. Atrial electromechanical time (PA) was measured by tissue doppler lateral mitral annulus (PA lateral), septal mitral annulus (PA septum) and right ventricular tricuspid annulus (PA tricuspid). P-wave dispersion (PDD) was obtained by subtracting the minimum P (Pmin) time from the maximum P (Pmax) wave time that can be measured in twelve-lead electrocardiography. The results were compared with GDM and control groups. Results: No difference was found between the two groups in terms of age, gestational week and demographic characteristics. P wave dispersion was 52.7 ± 5.1 ms in the GDM group and 28.9 ± 4.2 ms in the control group (p <0.001). In the GDM group, PA lateral was 65.7 ± 4.2 ms and in the control group 47.7 ± 4.7 ms (p <0.001). In the GDM group, PA septal was 56.1 ± 3.4 ms and in the control group was 40.8 ± 3.7 ms (p <0.001). In the GDM group, PA tricuspid was 48.4 ± 3.9 ms in the control group and 36.0 ± 3.6 ms in the control group (p <0.001).Interatrial, intraatrial and intraleft atrial delay times were significantly higher in the GDM group (median values, respectively, 18ms versus 12ms, (p <0.001); 10ms versus 7.5ms, (p <0.001); 4 ms versus 4 ms, (p <0.001). There was a positive correlation between intraatrial delay time and P wave dispersion in GDM group (r:0,39, p = 0.033). Conclusion: The main finding of our study was the maximum P wave duration, minimum P wave duration and longer P wave dispersion in the GDM group compared to the controls. In addition, atrial conduction times were longer in GDM group. GDM patients should be monitored for atrial arrhythmias, in addition to blood sugar and gestational follow-up. Patients with high risk for the development of atrial fibrillation can be pre-determined and the formation of diseases, such as stroke, which is the most feared complication, can be prevented in advance. Keywords: Gestational diabetes mellitus, Atrial conduction time, P wave dispersion, Electromechanical delay