Department of Children's Diseases, Institute for Medical Education of the V.A. Almazov National Medical Research Centre, 2 Akkuratova Str., St Petersburg, 197341, Russia.
Department of Clinical Psychology, St. Petersburg State Institute for Psychology and Social Work, St Petersburg, Russia.
Sleep Breath. 2023 Mar;27(1):291-301. doi: 10.1007/s11325-022-02630-1. Epub 2022 Apr 30.
Prolonged atrial conduction and inhomogeneous sinus impulse propagation may play a role in the initiation and maintenance of atrial tachyarrhythmias. Such a process could be reflected in inter-lead P-wave duration differences known as "P-wave dispersion" (PWD). Abnormal PWD may be related to obstructive sleep apnea syndrome (OSAS). A meta-analysis of the available publications was conducted.
A MEDLINE, Web of Science, and Google Scholar search from 2000 to 2021 was performed. The keywords used for search were apnea AND "P wave dispersion." Case-control studies and surveys were selected as long as they included healthy subjects and subjects with diagnosed OSAS who did not have any other major health problems. PWD values and correlations between apnea-hypopnea indices (AHI) and PWD were used as outcome measures.
Ten studies met the inclusion creteria, encompassing 773 patients with OSAS and 347 healthy controls. The mean ages of the patients with OSAS ranged from 6.9 to 58.8 years. The estimated average Hedges's g standardized mean difference in PWD values was equal to 1.883 (95% CI: 1.140 to 2.626, p < 0.001). The estimated average Fisher r-to-z transformed correlation coefficient between AHI and PWD was equal to 0.530 (95% CI: 0.075 to 0.985, p = 0.0225). Meta-regression analysis failed to find statistically significant correlations between the effect sizes and the mean age, male proportion, and the body mass index in the OSAS groups.
OSAS is associated with increased PWD, which may predispose to atrial tachyarrythmias.
心房传导延长和不均匀的窦房结冲动传播可能在房性心动过速的发生和维持中起作用。这种过程可以反映在导联间 P 波持续时间差异上，称为“P 波离散度”（PWD）。异常的 PWD 可能与阻塞性睡眠呼吸暂停综合征（OSAS）有关。对现有文献进行了荟萃分析。
对 2000 年至 2021 年的 MEDLINE、Web of Science 和 Google Scholar 进行了检索。用于搜索的关键词是 apnea 和 "P 波离散度"。只要纳入了健康受试者和诊断为 OSAS 的受试者的病例对照研究和调查，且这些受试者没有任何其他重大健康问题，就将其纳入研究。使用 PWD 值和睡眠呼吸暂停低通气指数（AHI）与 PWD 之间的相关性作为结局指标。
10 项研究符合纳入标准，共纳入 773 例 OSAS 患者和 347 例健康对照者。OSAS 患者的平均年龄为 6.9 岁至 58.8 岁。PWD 值的 Hedges's g 标准化均数差估计值为 1.883（95%CI：1.140 至 2.626，p<0.001）。AHI 与 PWD 之间的 Fisher r-to-z 转换相关系数的估计平均值为 0.530（95%CI：0.075 至 0.985，p=0.0225）。元回归分析未发现 OSAS 组的效应大小与平均年龄、男性比例和体重指数之间存在统计学上的显著相关性。
OSAS 与 PWD 增加有关，这可能使心房性心动过速更容易发生。
