Magnani Jared W, Johnson Victor M, Sullivan Lisa M, Lubitz Steven A, Schnabel Renate B, Ellinor Patrick T, Benjamin Emelia J
Section of Cardiovascular Medicine, Boston University School of Medicine, Boston, MA, USA.
Ann Noninvasive Electrocardiol. 2010 Oct;15(4):344-52. doi: 10.1111/j.1542-474X.2010.00390.x.
P-wave indices, an electrocardiographic phenotype reflecting atrial electrophysiology and morphology, may be altered in multiple disease states or by cardiovascular risk factors. Reference values for P-wave indices, providing cut points for their classification and interpretation, have not yet been established and are essential toward facilitating clinical application and comparison between studies.
We randomly selected 20 men and 20 women from 10-year age intervals between <25 years to 76-85 years from the Framingham Heart Study Original and Offspring Cohorts, excluding subjects with prevalent cardiovascular disease, hypertension, diabetes or obesity. The total included 295 subjects; eligibility in women >75 years was limited by exclusion criteria. We used a digital measurement technique with demonstrated intrarater reproducibility to determine P-wave indices. P-wave indices examined included the maximum, mean, lead II and PR durations, dispersion, and the standard deviation of duration.
All P-wave indices were significantly (P < 0.0001) correlated with advancing age. Means of all P-wave indices were lower in women as compared to men. PR-interval duration was strongly correlated with maximum, mean, and lead II mean P-wave durations. In multivariable models adjusting for significant anthropometric and clinical associations risk factors, significant differences persisted by age and sex in P-wave indices.
In our healthy sample without cardiovascular disease, hypertension, diabetes, or obesity, men and older subjects had longer mean P-wave indices. Our description of P-wave indices establishes reference values for future comparative studies and facilitates the classification of P-wave indices.
P波指标是反映心房电生理和形态的心电图表型，在多种疾病状态或心血管危险因素作用下可能发生改变。P波指标的参考值尚未确定，而参考值可为其分类和解读提供切点，对于促进临床应用及不同研究间的比较至关重要。
我们从弗雷明汉心脏研究原始队列和子代队列中，按10岁年龄间隔，在小于25岁至76 - 85岁之间随机选取20名男性和20名女性，排除患有心血管疾病、高血压、糖尿病或肥胖的受试者。共纳入295名受试者；75岁以上女性的入选受排除标准限制。我们使用一种具有良好观察者内重复性的数字测量技术来确定P波指标。所检测的P波指标包括最大值、平均值、II导联和PR间期持续时间、离散度以及持续时间的标准差。
所有P波指标均与年龄增长显著相关（P < 0.0001）。与男性相比，所有P波指标的平均值在女性中较低。PR间期持续时间与P波最大、平均和II导联平均持续时间密切相关。在调整了显著的人体测量学和临床相关危险因素的多变量模型中，P波指标在年龄和性别上仍存在显著差异。
在我们这个无心血管疾病、高血压、糖尿病或肥胖的健康样本中，男性和老年受试者的平均P波指标更长。我们对P波指标的描述为未来的比较研究建立了参考值，并有助于P波指标的分类。
