Arslan Derya, Cimen Derya, Guvenc Osman, Oran Bulent, Yilmaz Fatma Hilal
1Department of Pediatric Cardiology, Medical Faculty,Selcuk University,Konya,Turkey.
2Department of Pediatrics, Medical Faculty,Selcuk University,Konya,Turkey.
Cardiol Young. 2014 Oct;24(5):918-22. doi: 10.1017/S1047951113001431. Epub 2013 Sep 25.
This was a prospective controlled study to determine the P-wave duration and P-wave dispersion in patients with atrial septal aneurysm.
A total of 41 children with atrial septal aneurysm, including 21 boys and 20 girls (mean age 11.85 ± 3.8 years), and 32 controls, including 17 boys and 15 girls (mean age 12.3 ± 2.9 years), were included. P-wave dispersion was calculated from the 12-lead electrocardiogram. Cardiac functions, morphology of the aneurysm, and left atrial diameter were measured using conventional echocardiography. The diagnosis of atrial septal aneurysm was made when the base of the aneurysms with an excursion ratio ≥25% was found on echocardiography.
There was no significant difference between the patient and control groups in demographic, clinical findings, and M-mode echocardiographic parameters. The P-wave dispersion in patients with atrial septal aneurysm was significantly longer compared with the control group (64.4 ± 13.4 ms; p < 0.0001). Similarly, the the maximum duration of the P wave in the patient group was significantly longer compared with the control group (106.1 ± 13.3 ms; p < 0.001). The P-wave duration and dispersion were not correlated with age, gender, systolic and diastolic blood pressure, or m-mode echocardiographic parameters.
This study shows that P-wave dispersion is delayed in atrial septal aneurysm patients. Prolonged P-wave dispersion was determined to indicate electrical disturbance, and therefore it has an increased electrocardiographic risk of atrial arrhythmia in children with atrial septal aneurysm.
这是一项前瞻性对照研究,旨在确定房间隔瘤患者的P波时限和P波离散度。
共纳入41例房间隔瘤患儿,其中男21例,女20例(平均年龄11.85±3.8岁),以及32例对照者,其中男17例,女15例(平均年龄12.3±2.9岁)。P波离散度通过12导联心电图计算得出。使用传统超声心动图测量心功能、瘤体形态和左心房直径。当超声心动图发现瘤体基底偏移率≥25%时诊断为房间隔瘤。
患者组和对照组在人口统计学、临床发现及M型超声心动图参数方面无显著差异。房间隔瘤患者的P波离散度显著长于对照组(64.4±13.4毫秒;p<0.0001)。同样,患者组P波最大时限也显著长于对照组(106.1±13.3毫秒;p<0.001)。P波时限和离散度与年龄、性别、收缩压和舒张压或M型超声心动图参数无关。
本研究表明房间隔瘤患者存在P波离散度延迟。P波离散度延长被确定为提示电紊乱,因此房间隔瘤患儿发生房性心律失常的心电图风险增加。