READERS OPINION
Electrocardiographic data should be coupled with tissue-Doppler imaging and clinical follow-up evaluation to determine cardiac involvement in lichen planus
Uğur Canpolat
, Osman Turak, Fırat Özcan, Dursun Aras, Sinan Aydoğdu
Corresponding author
Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, 06100, Ankara/Turkey
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"abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">RAPID COMMUNICATION</span>" "titulo" => "Early transconjunctival needling revision with 5-fluorouracil <span class="elsevierStyleItalic">versus</span> medical treatment in encapsulated blebs: a 12-month prospective study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1376" "paginaFinal" => "1379" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1-cln_68p1376" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 507 "Ancho" => 622 "Tamanyo" => 55006 ] ] "descripcion" => array:1 [ "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Encapsulated bleb – localized, dome-shaped bleb (arrows).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ricardo Suzuki, Remo Susanna-Jr" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Ricardo" "apellidos" => "Suzuki" ] 1 => array:2 [ "nombre" => "Remo" "apellidos" => "Susanna-Jr" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222029726?idApp=UINPBA00004N" "url" => "/18075932/0000006800000010/v1_202212010644/S1807593222029726/v1_202212010644/en/main.assets" ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">READERS OPINION</span>" "titulo" => "Electrocardiographic data should be coupled with tissue-Doppler imaging and clinical follow-up evaluation to determine cardiac involvement in lichen planus" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1380" "paginaFinal" => "1381" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Uğur Canpolat, Osman Turak, Fırat Özcan, Dursun Aras, Sinan Aydoğdu" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Uğur" "apellidos" => "Canpolat" "email" => array:1 [ 0 => "dru_canpolat@yahoo.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "Osman" "apellidos" => "Turak" ] 2 => array:2 [ "nombre" => "Fırat" "apellidos" => "Özcan" ] 3 => array:2 [ "nombre" => "Dursun" "apellidos" => "Aras" ] 4 => array:2 [ "nombre" => "Sinan" "apellidos" => "Aydoğdu" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, 06100, Ankara/Turkey" "identificador" => "af1-cln_68p1380" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Tel.: +90 542 843 07 71" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="para10" class="elsevierStylePara elsevierViewall">To the Editor,</p><p id="para20" class="elsevierStylePara elsevierViewall">In the recent issue of your journal, we were pleased to read an interesting article by Şahin et al. (<a class="elsevierStyleCrossRef" href="#bib1">1</a>) evaluating <span class="elsevierStyleItalic">p</span>-wave dispersion (PWd) in 58 patients with lichen planus (LP) compared to 37 age- and gender-matched healthy controls. The authors showed that PWd was higher in LP patients compared to healthy controls (39.9±12.9 msec <span class="elsevierStyleItalic">vs</span>. 32.4±11.8 msec, <span class="elsevierStyleItalic">p</span> = 0.005). Additionally, high-sensitivity C-reactive protein (hsCRP), low-density lipoprotein (LDL)-cholesterol and triglyceride levels were significantly higher in the LP group compared to the healthy controls. Furthermore, hsCRP levels were positively correlated with PWd.</p><p id="para30" class="elsevierStylePara elsevierViewall">Atrial fibrillation (AF) is the most common clinical arrhythmia and presents as heterogeneous and discontinuous intra- and/or inter-atrial conduction due to several insults (e.g., inflammatory status) that promote atrial structural remodeling and provide a substrate for AF (<a class="elsevierStyleCrossRef" href="#bib2">2</a>). In previous studies, Dilaveris et al. (<a class="elsevierStyleCrossRef" href="#bib3">3</a>) described a new ECG index (PWd) and demonstrated that a <span class="elsevierStyleItalic">p</span> maximum >110 msec and a PWd >40 msec were simple and noninvasive parameters for the prediction of paroxysmal lone AF; Aytemir et al. (<a class="elsevierStyleCrossRef" href="#bib4">4</a>) reported similar findings at a <span class="elsevierStyleItalic">p</span> maximum >106 msec and a PWd >36 msec. Thereafter, <span class="elsevierStyleItalic">p</span>-wave indices have been applied in a wide range of clinical contexts (<a class="elsevierStyleCrossRefs" href="#bib5">5–9</a>). The study by Şahin et al. (<a class="elsevierStyleCrossRef" href="#bib1">1</a>) was the first in the literature to evaluate this marker in LP patients. However, mean <span class="elsevierStyleItalic">p</span>-wave indices in the study by Şahin et al. (<a class="elsevierStyleCrossRef" href="#bib1">1</a>) were lower than described by Dilaveris et al. (<a class="elsevierStyleCrossRef" href="#bib3">3</a>) and Aytemir et al. (<a class="elsevierStyleCrossRef" href="#bib4">4</a>) in the prediction of paroxysmal lone AF. This result may be due to several differences among those studies, including different patient populations and risk factors and relatively short disease durations for the LP patients. Additionally, the study results should be interpreted in the context of the effects of LP on serum lipid levels (i.e., higher LDL-cholesterol and triglyceride levels), which are known as significant risk factors for chronic inflammation and AF development (<a class="elsevierStyleCrossRef" href="#bib10">10</a>,<a class="elsevierStyleCrossRef" href="#bib11">11</a>).</p><p id="para40" class="elsevierStylePara elsevierViewall">Moreover, despite the volume of studies on this topic, <span class="elsevierStyleItalic">p</span>-wave index reference values and measurement techniques have not been standardized. Therefore, echocardiographic and clinical follow-up data could assist with determining the impact of both cardiac and non-cardiac diseases on <span class="elsevierStyleItalic">p</span>-wave indices. Other studies have suggested that intra- and/or inter-atrial electromechanical delays measured by tissue-Doppler imaging could be useful markers for the prediction of paroxysmal AF along with PWd (<a class="elsevierStyleCrossRefs" href="#bib12">12–14</a>). In addition to the non-invasive measurements, clinical follow-up data are essential to predict several parameters of AF development accurately.</p><p id="para50" class="elsevierStylePara elsevierViewall">In conclusion, Şahin et al. highlighted LP as a chronic inflammatory condition and described the impact of this condition on atrial conduction using <span class="elsevierStyleItalic">p</span>-wave indices. However, tissue-Doppler imaging with echocardiography and the collection of clinical follow-up data related to AF development should be considered in future studies in addition to electrocardiographic evaluation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">No potential conflict of interest was reported.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased P-wave dispersion in patients with newly diagnosed lichen planus" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ M Sahin \n \t\t\t\t\t\t\t\t """ 1 => """ SG Bilgili \n \t\t\t\t\t\t\t\t """ 2 => """ H Simsek \n 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=> true "autores" => array:6 [ 0 => """ A Deniz \n \t\t\t\t\t\t\t\t """ 1 => """ B Yavuz \n \t\t\t\t\t\t\t\t """ 2 => """ K Aytemir \n \t\t\t\t\t\t\t\t """ 3 => """ M Hayran \n \t\t\t\t\t\t\t\t """ 4 => """ S Kose \n \t\t\t\t\t\t\t\t """ 5 => """ S Okutucu \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1540-8175.2008.00881.x" "Revista" => array:7 [ "tituloSerie" => "Echocardiography" "fecha" => "2009" "volumen" => "26" "numero" => "7" "paginaInicial" => "779" "paginaFinal" => "784" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19486122" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conduction characteristics in atrial fibrillation: Predictive value of tissue Doppler echocardiography" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => 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] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2012.01.024" "Revista" => array:7 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2012" "volumen" => "156" "numero" => "1" "paginaInicial" => "121" "paginaFinal" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22305816" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/18075932/0000006800000010/v1_202212010644/S1807593222029738/v1_202212010644/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/18075932/0000006800000010/v1_202212010644/S1807593222029738/v1_202212010644/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222029738?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 1 | 5 |
| 2024 October | 22 | 22 | 44 |
| 2024 September | 22 | 12 | 34 |
| 2024 August | 16 | 15 | 31 |
| 2024 July | 20 | 18 | 38 |
| 2024 June | 40 | 16 | 56 |
| 2024 May | 38 | 11 | 49 |
| 2024 April | 25 | 8 | 33 |
| 2024 March | 21 | 12 | 33 |
| 2024 February | 23 | 15 | 38 |
| 2024 January | 11 | 8 | 19 |
| 2023 December | 17 | 20 | 37 |
| 2023 November | 14 | 18 | 32 |
| 2023 October | 14 | 21 | 35 |
| 2023 September | 17 | 24 | 41 |
| 2023 August | 16 | 4 | 20 |
| 2023 July | 12 | 17 | 29 |
| 2023 June | 17 | 7 | 24 |
| 2023 May | 29 | 1 | 30 |
| 2023 April | 40 | 4 | 44 |
| 2023 March | 28 | 1 | 29 |
| 2023 February | 7 | 1 | 8 |
| 2023 January | 17 | 3 | 20 |
| 2022 December | 9 | 2 | 11 |
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