通过P波离散度检测窦性心律时存在阵发性心房颤动风险的肥厚型心肌病患者。
Detection of patients with hypertrophic cardiomyopathy at risk for paroxysmal atrial fibrillation during sinus rhythm by P-wave dispersion.
作者信息
Köse Sedat, Aytemir Kudret, Sade Elif, Can Ilknur, Ozer Necla, Amasyali Basri, Aksöyek Serdar, Ovünç Kenan, Ozmen Ferhan, Atalar Enver, Işik Ersoy, Kes Sirri, Demirtaş Ertan, Oto Ali
机构信息
Gülhane Military Medical Academy, Department of Cardiology, Ankara, Turkey.
出版信息
Clin Cardiol. 2003 Sep;26(9):431-4. doi: 10.1002/clc.4960260910.
BACKGROUND
Paroxysmal atrial fibrillation (PAF) in hypertrophic cardiomyopathy (HCM) is associated with poor prognosis. Previous studies have shown good correlation between P-wave dispersion (Pd) and occurrence of PAF. However, Pd in patients with HCM for predicting PAF has not been studied.
HYPOTHESIS
The aim of the study was to determine whether Pd could identify patients with HCM who are likely to suffer from PAF.
METHODS
Twenty-two patients with HCM with a history of PAF (Group 1) and 26 patients with HCM without a history of PAF (Group 2) were studied. Maximum (Pmax) and minimum (Pmin) P-wave durations, as well as P-wave dispersion (Pd = Pmax - Pmin) were calculated from 12-lead surface electrocardiograms (ECG).
RESULTS
P-wave dispersion was significantly different between the groups (Group 1: 55 +/- 6 ms vs. Group 2: 37 +/- 8 ms; p<0.001), while Pmax (Group 1: 134 +/- 11 ms vs. Group 2: 128 +/- 13 ms; p = 0.06) and Pmin (Group 1: 78 +/- 9 ms vs. Group 2: 81 +/- 7 ms; p = 0.07) was not significantly different. Patients with a history of PAF had higher left atrial diameter than the patients without PAF (Group 1: 52 +/- 8 mm vs. Group 2: 48 +/- 10 mm; p = 0.02). A cut-off value of 46 ms for Pd had a sensitivity of 76% and a specificity of 82% in discriminating between patients with and without PAF.
CONCLUSION
This study suggests that P-wave dispersion could identify patients with HCM who are likely to develop PAF.
背景
肥厚型心肌病（HCM）中的阵发性心房颤动（PAF）与预后不良相关。先前的研究表明P波离散度（Pd）与PAF的发生之间存在良好的相关性。然而，尚未对HCM患者中用于预测PAF的Pd进行研究。
假设
本研究的目的是确定Pd是否能够识别可能发生PAF的HCM患者。
方法
对22例有PAF病史的HCM患者（第1组）和26例无PAF病史的HCM患者（第2组）进行研究。从12导联体表心电图（ECG）计算最大（Pmax）和最小（Pmin）P波时限以及P波离散度（Pd = Pmax - Pmin）。
结果
两组之间的P波离散度有显著差异（第1组：55±6毫秒 vs. 第2组：37±8毫秒；p<0.001），而Pmax（第1组：134±11毫秒 vs. 第2组：128±13毫秒；p = 0.06）和Pmin（第1组：78±9毫秒 vs. 第2组：81±7毫秒；p = 0.07）无显著差异。有PAF病史的患者左心房直径大于无PAF病史的患者（第1组：52±8毫米 vs. 第2组：48±10毫米；p = 0.02）。Pd的截断值为46毫秒时，区分有无PAF患者的敏感性为76%，特异性为82%。
结论
本研究表明，P波离散度可识别可能发生PAF的HCM患者。
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