Tereshchenko Larisa G, Shah Amit J, Li Yabing, Soliman Elsayed Z
Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA.
J Cardiovasc Electrophysiol. 2014 Nov;25(11):1242-8. doi: 10.1111/jce.12453. Epub 2014 Jun 11.
Deep terminal negativity of P wave in V1 (DTNPV1), defined as negative P prime larger than one small box (1 mm, or 0.1 mV), could be easily detected by simple visual inspection of the resting 12-lead ECG. The objective of this study was to determine the relationship between DTNPV1 and all-cause-, cardiovascular disease (CVD), and ischemic heart disease (IHD) mortality in the National Health and Nutrition Examination Survey III (NHANES III).
After exclusion of participants with atrial fibrillation and missing data, DTNPV1 was automatically measured from standard 12-lead ECG in 8,146 participants. Minnesota and Novacode algorithms were used for the determination of major and minor ECG abnormalities. National Death Index was used to identify the date and cause of death. During a median follow-up of 13.8 years, a total of 2,975 deaths (1,303 CVD and 742 IHD deaths) occurred. After adjustment for age, gender, race/ethnicity, IHD, heart failure, chronic obstructive pulmonary disease, cancer, diabetes, body mass index, smoking, dyslipidemia, hypertension, use of antihypertensive and lipid-lowering medications, and ECG abnormalities, DTNPV1 was associated with significantly increased risk of all-cause death (HR [95% CI]: 1.30 [1.10, 1.53]; P = 0.002), CVD death (HR [95% CI]: 1.36 [1.08, 1.72]; P = 0.010), and IHD death (HR [95% CI]: 1.36 [1.00, 1.85]; P = 0.047).
In a large sample of the adult United States population, DTNPV1 is independently associated with increased risk of death due to all-cause, CVD, and IHD, findings suggesting its potential usefulness as a simple marker to identify individuals at risk of poor outcomes.
V1导联P波深终末负向波（DTNPV1）定义为负向P′波大于一个小格（1毫米，即0.1毫伏），通过对静息12导联心电图进行简单的视觉检查即可轻松检测到。本研究的目的是确定在第三次全国健康与营养检查调查（NHANES III）中DTNPV1与全因死亡率、心血管疾病（CVD）死亡率和缺血性心脏病（IHD）死亡率之间的关系。
在排除心房颤动参与者和缺失数据后，对8146名参与者的标准12导联心电图自动测量DTNPV1。采用明尼苏达和诺瓦代码算法确定主要和次要心电图异常。使用国家死亡指数确定死亡日期和原因。在中位随访13.8年期间，共发生2975例死亡（1303例CVD死亡和742例IHD死亡）。在调整年龄、性别、种族/族裔、IHD、心力衰竭、慢性阻塞性肺疾病、癌症、糖尿病、体重指数、吸烟、血脂异常、高血压、使用抗高血压和降脂药物以及心电图异常后，DTNPV1与全因死亡风险显著增加相关（HR [95% CI]：1.30 [1.10, 1.53]；P = 0.002），CVD死亡风险（HR [95% CI]：1.36 [1.08, 1.72]；P = 0.010）和IHD死亡风险（HR [95% CI]：1.36 [1.00, 1.85]；P = 0.047）。
在美国成年人群的大样本中，DTNPV1与全因、CVD和IHD导致的死亡风险增加独立相关，这些发现表明其作为识别预后不良个体风险的简单标志物具有潜在用途。
