Impact of obstructive sleep apnea on the atrial electromechanical activation time

Hong Euy Lim, Yong Hyun Kim, Seong Hwan Kim, Eung Ju Kim, Hui Nam Pak, Young Hoon Kim, Inkyung Baik, Chol Shin

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background Obstructive sleep apnea (OSA) is closely associated with atrial fibrillation, which is provoked by electrical and structural remodeling. However, the association between OSA and atrial remodeling has not been fully elucidated. Methods and Results Atrial electromechanical activation time (EMAT) was investigated using tissue Doppler imaging (TDI) in men with severe OSA (n=24) and control subjects (n=24). The EMAT was determined as the time interval from the initiation of P-wave deflection until the peak of local lateral left atrial (LA) TDI signal. The early diastolic velocity of the mitral annulus (Ea) and the EMAT were significantly lower and longer in OSA cases than in controls (Ea: 6.1±0.9 cm/s vs 7.3±1.5 cm/s, P=0.001; EMAT: 129.7±11.5 ms vs 118.5±12.3 ms, P=0.002). Among OSA cases, the apnea - hypopnea index (AHI) was significantly correlated with EMAT (r=0.660, P<0.001), Ea (r=-0.609, P=0.002), LA dimension (r=0.486, P=0.016), and early diastolic velocity of mitral flow (E)/Ea ratio (r=0.418, P=0.042). In multivariate stepwise linear regression analysis, EMAT was independently associated with AHI (P=0.025) and Ea (P=0.028) in OSA cases. Conclusion EMAT measured by TDI could be a useful parameter for identifying atrial remodeling in patients with severe OSA.

Original languageEnglish
Pages (from-to)249-255
Number of pages7
JournalCirculation Journal
Issue number2
Publication statusPublished - 2009


  • Apnea-hypopnea index
  • Atrial remodeling
  • Obstructive sleep apnea
  • Tissue doppler imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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