How does P wave dispersion change in patients with Wilson's disease?

Wilson's disease is a severe inherited metabolic disorder, which is associated with intracellular copper overload and multiple organ involvement. Main cardiac manifestations in Wilson's disease include arrhythmias and cardiac failure. Recently, researchers at the Ankara Y¨¹ksek Ihtisas Hospital and in Ankara University Faculty of Medicine investigated P wave dispersion (PWD) as a non-invasive marker of intra-atrial conduction disturbance in patients with Wilson's disease.

This research, led by Dr. Nurcan Arat is to be published on February 28, 2008 in the World Journal of Gastroenterology.

All the patients were asymptomatic on cardiological examination and had no rhythm disturbances in electrocardiography. Left ventricular and left atrial diameters and left ventricular function were similar in both groups. The Wilson's disease patients had a significantly higher P wave dispersion when compared with the controls. This significant dispersion may correlate to atrial conductance abnormalities like atrial fibrillation.

PWD was significantly higher in Wilson's patients than in the control group. PWD was significantly correlated with the age at diagnosis and serum copper level in patients with Wilson's disease. The team was not able to find any statistically significant correlation between PWD and other clinical and echocardiographic evaluations.

Dr. Arat, leader of the research team, underlined the importance of finding a new non-invasive tool, PWD, to foresee the possible devastating cardiac manifestations like arrhythmias which even asymptomatic patients can suffer from.

Though Wilson's disease is a rare genetic disorder and not a general health problem, the population within this study is large enough to take lessons for the future. Adopting this methodology, both affected people and care giving physicians will have the opportunity to evaluate the risk of cardiac disturbances.

To generate a Wilson's disease population is a tough task. The collaborators within the study did manage, however, to gather a non-negligible number of patients together in Turkey. This clinical research was performed using the resources of Ankara Y¨¹ksek Ihtisas Hospital. Ankara University Department of Gastroenterology supported them with recruiting additional Wilson's disease patients to the study.

Further research and long term follow-up will confirm and explain the positive PWD data in Wilson's disease patients according to findings of this initiative study.

Reference: Arat N, Kacar S, Golbasi Z, Akdo an M, SokmenY, Kuran S, Idilman R. P wave dispersion is prolonged in patients with Wilson's disease. World J Gastroenterol 2008; 14(8): 1252-1256
http://www.wjgnet.com/1007-9327/14/1252.asp

Correspondence to: Nurcan Arat, T¨¹rkiye Y¨¹ksek Ihtisas Hospital, Clinic of Cardiology, Sihhiye 06100, Ankara, Turkey. aratnurcan@gmail.com
Telephone: +90-505-502 5077 Fax: +90-312-362 4502

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