From the Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay.
Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de la Mora, Paraguay.
Crit Pathw Cardiol. 2023 Dec 1;22(4):141-145. doi: 10.1097/HPC.0000000000000328. Epub 2023 Aug 4.
There is a global tendency to emphasize the prevention and early diagnosis of diseases that have a great impact on public health. Atrial fibrillation (AF) has a prevalence affecting 1.5-2% of the general population. Certain variables of the P wave allow us to identify and stratify patients at risk of developing AF.
This is an observational, descriptive, and longitudinal study to determine the applicability of the electrocardiographic (ECG) morphology, voltage, and P wave duration (MVP) risk score to predict the development of AF in consecutive patients with systemic hypertension (SH) in an initial follow-up of 12 months.
Initially, 104 patients were included, of whom 12 died during follow-up and 17 did not attend subsequent checkups during the COVID-19 pandemic; therefore, they were excluded. The study patients were 75, of whom AF was detected in 25 patients (33%). The average duration of the P wave was 120 ± 26 ms, the average voltage was 0.1 ± 0.5 Mv. The high-risk MVP ECG score had an [area under the curve, 0.69; 95% confidence intervals (CI), 0.59-0.79] and demonstrated a specificity and a positive predictive value of 100%, a negative predictive value of 76%, and a sensitivity of 40% for predicting the development of AF.
The present study establishes for the first time that SH patients who possess a high-risk MVP ECG score have a significantly higher incidence of developing AF. The high-risk MVP Score has a specificity and a positive predictive value of 100% and a high negative predictive value with a moderate sensitivity for the prediction of the development of AF in SH patients.
强调预防和早期诊断对公众健康有重大影响的疾病是一种全球趋势。房颤（AF）的患病率影响 1.5-2%的普通人群。P 波的某些变量可帮助我们识别和分层有发生 AF 风险的患者。
这是一项观察性、描述性和纵向研究，旨在确定心电图（ECG）形态、电压和 P 波持续时间（MVP）风险评分在 12 个月的初始随访中对预测连续高血压（SH）患者 AF 发展的适用性。
最初纳入了 104 例患者，其中 12 例在随访期间死亡，17 例在 COVID-19 大流行期间未参加后续检查，因此被排除在外。研究患者为 75 例，其中 25 例（33%）检测到 AF。P 波平均持续时间为 120±26ms，平均电压为 0.1±0.5Mv。高风险 MVP ECG 评分的[曲线下面积，0.69；95%置信区间（CI），0.59-0.79]和显示出 100%的特异性和阳性预测值、76%的阴性预测值和 40%的敏感性，用于预测 AF 的发展。
本研究首次证实，具有高风险 MVP ECG 评分的 SH 患者发生 AF 的发生率显著更高。高风险 MVP 评分对 SH 患者 AF 发展的预测具有 100%的特异性和阳性预测值以及高阴性预测值和中等敏感性。
