Shen Youmei, Li Mingfang, Chen Minglong
Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Ann Noninvasive Electrocardiol. 2022 Jul;27(4):e12969. doi: 10.1111/anec.12969. Epub 2022 May 21.
Deep terminal negativity of the P-wave in V1 (DTNPV1) was considered if the absolute value of the depth of the negative phase was >100 μV in the presence of a biphasic P-wave in V1. In this study, we aimed to determine the association between DTNPV1, a simpler P-wave index, and the risk of stroke.
We compared P-wave indices between participants with and without a self-reported history of stroke in the United States Third National Health and Nutrition Examination Survey (NHANES III). The association between DTNPV1 and stroke was quantified with logistic regression models.
In total, 7732 participants were included (307 with a history of stroke). Patients with stroke had deeper terminal negativity of the P-wave in V1 (52.3 ± 33.9 μV vs. 41.4 ± 27.0 μV, p < .001). After adjustment, DTNPV1 was associated with an increased risk of stroke (OR: 1.63, 95% CI: 1.03-2.60, p = .038). This association appeared to be stronger in people aged <75 years (interaction p = .023), and in those without heart failure (interaction p = .018) or ischemic heart disease (interaction p = .014). In contrast to the participants with 0 or ≥2 risk factors, in those with 1 risk factor, stroke prevalence was significantly different among the three categories of terminal negativity of the P-wave (0 μV, >0 μV but ≤100 μV and > 100 μV) in V1 (2.8%, 3.3%, and 10.3%, respectively, p = .005).
In NHANES III, DTNPV1 was associated with a higher prevalence of stroke, suggesting that DTNPV1 might be a convenient marker to distinguish the risk of stroke.
如果V1导联P波呈双相，且负向波深度绝对值>100 μV，则考虑存在V1导联P波深终末负向波（DTNPV1）。在本研究中，我们旨在确定更简单的P波指标DTNPV1与中风风险之间的关联。
我们在美国第三次全国健康与营养检查调查（NHANES III）中比较了有和没有自我报告中风病史的参与者之间的P波指标。用逻辑回归模型量化DTNPV1与中风之间的关联。
总共纳入了7732名参与者（307名有中风病史）。中风患者V1导联P波的终末负向波更深（52.3±33.9 μV对41.4±27.0 μV，p<.001）。调整后，DTNPV1与中风风险增加相关（OR：1.63，95%CI：1.03-2.60，p=.038）。这种关联在<75岁的人群中似乎更强（交互作用p=.023），在没有心力衰竭（交互作用p=.018）或缺血性心脏病（交互作用p=.014）的人群中也是如此。与有0个或≥2个风险因素的参与者相比，在有1个风险因素的参与者中，V1导联P波终末负向波的三个类别（0 μV、>0 μV但≤100 μV和>100 μV）的中风患病率有显著差异（分别为[X]%、[X]%和[X]%，p=.005）。
在NHANES III中，DTNPV1与中风的较高患病率相关，表明DTNPV1可能是区分中风风险的便捷标志物。
