Ariyarajah Vignendra, Mercado Kristin, Apiyasawat Sirin, Puri Puneet, Spodick David H
Massachusetts Veterans Epidemiology Research and Information Center, Preventive Cardiology, MAVERIC, Veterans Affair Boston Health Care System, and Department of Medicine, 150 South Huntington Ave, Boston, MA 02130, USA.
Chest. 2005 Oct;128(4):2615-8. doi: 10.1378/chest.128.4.2615.
Interatrial block (IAB) [P-wave duration > or = 110 ms] is associated with left atrial (LA) enlargement (LAE) and pathophysiologic derangements that result in atrial tachyarrhythmias, LA electromechanical dysfunction, and embolism. However, there has been no study addressing the direct correlation of P-wave duration in IAB and LAE.
One hundred eighty-one consecutive patients who were admitted to a tertiary care teaching hospital over 5 consecutive days were screened for past transthoracic echocardiogram evaluations and were then matched with ECGs done within 10 days of these echocardiographic investigations. ECGs were evaluated for presence of IAB, and patients were subsequently classified into two groups: control patients and patients with IAB. Patients were also matched for common comorbidities. Mean, SD of age, Pearson correlation coefficient (r), p values, and multivariate and linear regression analyses were analyzed for the investigated variables of LA size, left ventricular hypertrophy (LVH), posterior wall thickness, septal thickness, and P-wave duration.
From the sample (n = 66; mean age +/- SD, 71.3 +/- 13.7; female gender, 48.5%), the mean LA size in the control group was 36.7 +/- 4.01 mm and for the group of patients with IAB (n = 38) was 42.2 +/- 7.25 mm (p = 0.004). Linear regression analysis revealed that P-wave duration was significantly correlated with LA size (p = 0.0002, r = 0.606).
Degree of conduction delay in IAB (P-wave duration) is an independent, direct correlate of LAE, and the regression equation (LA size [in millimeters] = 2.47 +/- 0.29 x P-wave duration [in milliseconds]) could be used to estimate LAE.
心房传导阻滞（IAB）[P波时限≥110毫秒]与左心房（LA）扩大（LAE）以及导致房性快速心律失常、LA机电功能障碍和栓塞的病理生理紊乱相关。然而，尚无研究探讨IAB中P波时限与LAE的直接相关性。
连续5天入住一家三级护理教学医院的181例患者接受了既往经胸超声心动图评估筛查，然后与这些超声心动图检查后10天内进行的心电图进行匹配。评估心电图是否存在IAB，患者随后分为两组：对照组患者和IAB患者。患者还根据常见合并症进行匹配。对LA大小、左心室肥厚（LVH）、后壁厚度、室间隔厚度和P波时限等研究变量分析了平均值、年龄标准差、皮尔逊相关系数（r）、p值以及多变量和线性回归分析。
在样本中（n = 66；平均年龄±标准差，71.3±13.7；女性，48.5%），对照组的平均LA大小为36.7±4.01毫米，IAB患者组（n = 38）为42.2±7.25毫米（p = 0.004）。线性回归分析显示，P波时限与LA大小显著相关（p = 0.0002，r = 0.606）。
IAB中的传导延迟程度（P波时限）是LAE的独立直接相关因素，回归方程（LA大小[毫米]=2.47±0.29×P波时限[毫秒]）可用于估计LAE。
