Assessment of P-Wave Dispersion and Atrial Electromechanical Delay in Patients with Non-Obstructive Coronary Artery Myocardial Infarction

We investigated p-wave dispersion (Pd) and atrial electromechanical delay (EMD) in patients diagnosed with non-obstructive coronary artery disease and myocardial infarction (MINOCA). 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. 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. 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). 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.