P Wave Dispersion in Juvenile Idiopathic Arthritis Patients With Diastolic Dysfunction|
Koca, Bülent; Bakari, Süleyman; Kasapçopur, Özgür; Çelik, Emre; Öztunç, Funda; Eroğlu, Ayşe Güler & Saltik, Levent
Objective: Cardiac involvement as pericarditis, myocarditis and valvular disease is common in juvenile
idiopathic arthritis (JIA). However, there are few studies concerning systolic and diastolic functions of the left
ventricle in children with JIA. P wave dispersion is a sign for the prediction of atrial fibrillation. A recent study
found that rheumatoid arthritis patients had an abnormally high P wave duration and P wave dispersion,
markers for supraventricular arrhythmogenicity. In this study, we aimed to evaluate P wave dispersion and
its relation with diastolic dysfunction of the left ventricle in patients with JIA.
Methods: We performed electrocardiography and Doppler echocardiography on patients and controls.
Maximum and minimum P wave duration were obtained from electrocardiographic measurements. P wave
dispersion defined as the difference between maximum and minimum P wave duration was also calculated.
Findings: No statistically significant differences were found between the patients and controls in minimum,
maximum P wave duration and P wave dispersion. Among the diastolic parameters in patients group,
increased late flow velocity, decreased early flow velocity and prolonged isovolumic relaxation time reflected
Conclusion: During 12 months of follow-up, no supraventricular arrhythmias were documented in JIA with
diastolic dysfunction. JIA with diastolic dysfunction has normal atrial conduction parameters and therefore
seemingly do not have an increased risk of atrial fibrillation.
Juvenile idiopathic arthritis; Echocardiography; Arrhythmia; Diastolic dysfunction