Yavuzkir Mustafa, Atmaca Murad, Dagli Necati, Balin Mehmet, Karaca Ilgin, Mermi Osman, Tezcan Ertan, Aslan I Nadi
Department of Cardiology, Firat University, School of Medicine, Elazig, Turkey.
Psychosom Med. 2007 May;69(4):344-7. doi: 10.1097/PSY.0b013e3180616900. Epub 2007 May 17.
P-wave dispersion (PWD) is defined as the difference between the maximum and the minimum P-wave (Pmax and Pmin, respectively) duration. Significant variation in cardiac atrial PWD has been correlated with changes in systemic autonomic tone such as during periods of anxiety. It is also known that the degree of PWD seen on 12-lead electrocardiogram (ECG) may be a predictor of susceptibility of the atrial myocardium to future atrial fibrillation (AF). Therefore, we firstly aimed to show an association between PWD and panic disorder, a state of high sympathetic tone.
PWD was measured in 40 outpatients with panic disorder and in 40 physically and mentally healthy age- and gender-matched controls. In addition, the Panic Agoraphobia Scale (PAS) and the Hamilton Depression Rating Scale (HDRS) were scored concomitantly.
Both Pmax and Pmin were significantly higher than those of healthy controls. PWD was significantly greater in the panic disorder group than in the controls. As expected, the mean score on PAS was significantly higher for the panic disorder group than for the controls and correlated significantly with PWD. Heart rate (measured as RR intervals in milliseconds on electrocardiogram) did not differ significantly between the groups.
The findings of the present study suggest that the disorder may be associated with an increase in PWD. This association may result from prolonged anxiety and increase in sympathetic modulation, which are main characteristics of panic disorder.
P波离散度（PWD）定义为最大和最小P波（分别为Pmax和Pmin）时限之间的差值。心脏心房PWD的显著变化与全身自主神经张力的改变相关，如在焦虑期间。还已知12导联心电图（ECG）上所见的PWD程度可能是心房心肌对未来心房颤动（AF）易感性的一个预测指标。因此，我们首先旨在表明PWD与惊恐障碍（一种高交感神经张力状态）之间的关联。
对40例惊恐障碍门诊患者和40例年龄、性别匹配的身心健康对照者测量PWD。此外，同时对惊恐广场恐怖量表（PAS）和汉密尔顿抑郁量表（HDRS）进行评分。
Pmax和Pmin均显著高于健康对照者。惊恐障碍组的PWD显著大于对照组。正如预期的那样，惊恐障碍组的PAS平均得分显著高于对照组，且与PWD显著相关。两组间心率（以心电图上RR间期毫秒数测量）无显著差异。
本研究结果表明，该疾病可能与PWD增加有关。这种关联可能是由惊恐障碍的主要特征——长期焦虑和交感神经调节增加所致。
