Faculty of Medicine and Health Technology, Tampere University, Finnish Cardiovascular Research Center, Tampere, Finland; Department of Cardiology, Vaasa Central Hospital, Vaasa, Finland.
Heart Center, Central Hospital of North Karelia, Joensuu, Finland.
J Electrocardiol. 2022 Jul-Aug;73:12-20. doi: 10.1016/j.jelectrocard.2022.04.006. Epub 2022 Apr 27.
Partial and advanced interatrial block (IAB) and P terminal force (PTF) in lead V1 are markers of atrial remodeling and risk factors for atrial fibrillation (AF). There is a lack of information about constancy and possible factors influencing the development of these P-wave abnormalities.
The study sample consisted of 6058 Finnish participants (mean age 52.16 ± 14.60 years, 45.0% male) from the general population with an ECG taken in a health examination, and from 3224 of these participants, who had a re-examination 11 years later. Risk factors for incident partial and advanced IAB and PTF were studied using binomial logistic regression analysis, and the prognostic significance of these ECG changes for new AF was studied using time-varying Cox regression analysis.
The rate of reversal to normal of the studied ECG parameters were 47.4% for partial IAB, 40.0% for advanced IAB and 79.3% for PTF. Age, male sex, hypertension, higher BMI, higher LDL cholesterol, ECG left ventricular hypertrophy, use of beta blocker, and use of angiotensin-converting enzyme inhibitor or angiotensin II receptor antagonist were independently associated with a risk to develop incident P-wave abnormality. Partial IAB was independently associated with increased AF risk (HR 1.28 [95% CI 1.04-1.58]), as was also advanced IAB (HR 1.72 [95% CI 1.07-2.75]).
Traditional cardiovascular risk factors increase the risk of a new P-wave abnormality. Partial and advanced IAB are associated with increased AF risk. Surprisingly, P-wave abnormalities are often reversible during long-term follow-up in the general population.
部分和晚期房内阻滞（IAB）和 V1 导联 P 终端力（PTF）是心房重构的标志物和心房颤动（AF）的危险因素。关于这些 P 波异常的恒定性和可能的影响因素的信息还很缺乏。
研究样本包括来自一般人群的 6058 名芬兰参与者（平均年龄 52.16±14.60 岁，45.0%为男性），他们在健康检查时接受了心电图检查，其中 3224 名参与者在 11 年后进行了复查。使用二项逻辑回归分析研究了新发部分和晚期 IAB 和 PTF 的危险因素，使用时变 Cox 回归分析研究了这些心电图变化对新发 AF 的预后意义。
研究心电图参数的正常逆转率分别为部分 IAB 的 47.4%、晚期 IAB 的 40.0%和 PTF 的 79.3%。年龄、男性、高血压、较高的 BMI、较高的 LDL 胆固醇、心电图左心室肥厚、β受体阻滞剂的使用以及血管紧张素转换酶抑制剂或血管紧张素 II 受体拮抗剂的使用与新发 P 波异常的风险独立相关。部分 IAB 与 AF 风险增加独立相关（HR 1.28[95%CI 1.04-1.58]），晚期 IAB 也是如此（HR 1.72[95%CI 1.07-2.75]）。
传统心血管危险因素增加了新发 P 波异常的风险。部分和晚期 IAB 与 AF 风险增加相关。令人惊讶的是，在一般人群的长期随访中，P 波异常往往是可逆的。
