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

Objectives We aimed to assess atrial conduction time and P-wave dispersion (PWD) in gestational diabetes mellitus (GDM) patients. Methods Thirty patients with GDM and 30 healthy pregnant women were included to the study. Atrial conduction times (PA) were calculated by the time interval from the onset of the P wave on the electrocardiography (ECG) to the onset of the late diastolic flow (Am wave) on echocardiography and from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum), and right ventricular tricuspid annulus (PA tricuspid). The difference between (PA lateral-PA tricuspid) was defined as interatrial electromechanical delay (EMD); the difference between (PA septum-PA tricuspid) as intra-atrial EMD; and the difference between (PA lateral-PA septal) as intraleft atrial EMD. Results Mean PWD was higher in GDM (52.7 +/- 5.1 ms vs. 28.9 +/- 4.2 ms, p < 0.001). PA lateral, PA septal and PA tricuspid were significantly higher in the GDM patients compared to the control group (65.7 +/- 4.2 ms vs. 47.7 +/- 4.7 ms, p < 0.001; 56.1 +/- 3.4 ms vs. 40.8 +/- 3.7 ms, p < 0.001 and 48.4 +/- 3.9 ms vs. 36.0 +/- 3.6 ms, p < 0.001, respectively). Interatrial, intra-atrial, and intraleft atrial EMDs were also significantly higher in the GDM group (median values: 18 ms vs. 12 ms; 10 ms vs 7.5 ms; 8 ms vs. 4 ms, respectively, p < 0.001 for all). There was a positive correlation between intra-atrial delay time and PWD in GDM group (r = 0.39, p = 0.033). Conclusion We suggest that patients with GDM have higher PWD and higher atrial conduction and EMD times compared to otherwise healthy pregnant control group.