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P 波参数与左心房容积指数和左心室舒张功能具有显著相关性。

Significant correlation of P-wave parameters with left atrial volume index and left ventricular diastolic function.

机构信息

Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Am J Med Sci. 2013 Jul;346(1):45-51. doi: 10.1097/MAJ.0b013e318265d8f7.

Abstract

BACKGROUND

The 12-lead electrocardiogram (ECG) is a commonly used tool to access left atrial enlargement, which is a marker of left ventricular diastolic dysfunction (LVDD). The aim of this study was to evaluate any association of the P-wave measurements in ECG with left atrial volume (LAV) index and LVDD.

METHODS

This study enrolled 270 patients. In this study, 4 ECG P-wave parameters corrected by heart rate, that is, corrected P-wave maximum duration (PWdurMaxC), corrected P-wave dispersion (PWdisperC), corrected P-wave area (PWareaC) and corrected mean P-wave duration (meanPWdurC), were measured. LAV and left ventricular diastolic parameters were measured from echocardiography. LVDD was defined as a pseudonormal or restrictive mitral inflow pattern.

RESULTS

The 4 P-wave parameters were significantly correlated with the LAV index after adjusting for age, sex, diabetes, hypertension, coronary artery disease, body mass index and diastolic blood pressure in multivariate analysis. The standardized β coefficients of PWdurMaxC, PWdisperC, meanPWdurC and PWareaC were 0.338, 0.298, 0.215 and 0.296, respectively. The 4 P-wave parameters were also significantly correlated with LVDD after multivariate logistic regression analysis. The odds ratios (95% confidence intervals) of PWdurMaxC, PWdisperC, meanPWdurC and PWareaC were 1.03 (1.01-1.04), 1.02 (1.04-1.04), 1.04 (1.02-1.07) and 1.01 (1.00-1.02), respectively.

CONCLUSIONS

This study demonstrated that PWdurMaxC, PWdisperC, meanPWdurC and PWareaC were important determinants of the LAV index and LVDD. Therefore, screening patients by means of the 12-lead ECG may be helpful in identifying a high-risk group of increased LAV index and LVDD.

摘要

背景

十二导联心电图(ECG)是一种常用于评估左心房扩大的工具,左心房扩大是左心室舒张功能障碍(LVDD)的标志物。本研究旨在评估心电图中 P 波测量与左心房容积(LAV)指数和 LVDD 的相关性。

方法

本研究纳入了 270 名患者。在本研究中,测量了经过心率校正的 4 个 ECG P 波参数,即校正后的 P 波最大持续时间(PWdurMaxC)、校正的 P 波离散度(PWdisperC)、校正的 P 波面积(PWareaC)和平均 P 波持续时间(meanPWdurC)。从超声心动图测量 LAV 和左心室舒张参数。LVDD 定义为假性正常或限制性二尖瓣血流模式。

结果

在多变量分析中,调整年龄、性别、糖尿病、高血压、冠心病、体重指数和舒张压后,这 4 个 P 波参数与 LAV 指数呈显著相关。PWdurMaxC、PWdisperC、meanPWdurC 和 PWareaC 的标准化β系数分别为 0.338、0.298、0.215 和 0.296。多元逻辑回归分析后,这 4 个 P 波参数也与 LVDD 显著相关。PWdurMaxC、PWdisperC、meanPWdurC 和 PWareaC 的比值比(95%置信区间)分别为 1.03(1.01-1.04)、1.02(1.04-1.04)、1.04(1.02-1.07)和 1.01(1.00-1.02)。

结论

本研究表明,PWdurMaxC、PWdisperC、meanPWdurC 和 PWareaC 是 LAV 指数和 LVDD 的重要决定因素。因此,通过 12 导联心电图筛查患者可能有助于识别 LAV 指数和 LVDD 升高的高危人群。

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