Scott C C, Leier C V, Kilman J W, Vasko J S, Unverferth D V
J Electrocardiol. 1983 Oct;16(4):363-6. doi: 10.1016/s0022-0736(83)80086-7.
This study correlates left atrial appendage cell size, atrial fibrosis and echocardiographic (echo) measurement of left atrial size with P wave morphology. Twelve patients with known mitral valve disease had echo measurements of left atrial size with P wave morphology. Twelve patients with known mitral valve disease had echo measurements of left atrial size prior to mitral valve surgery; patients had varying degrees of left atrial enlargement. The left atrial appendage, removed at the time of surgery, was stereologically assessed for percent fibrosis and the diameters of 50 cells were measured and averaged. These factors were correlated with P wave amplitude and duration in lead II, greatest length in any led, PR segment (end of P wave to onset of QRS), P to PR segment ratio (in lead II) and the PR interval. There was a good correlation of left atrial cell diameter with P wave amplitude (r = .69, p = 0.01). There was a good inverse correlation of percent fibrosis with the PR segment (r = -.72, p = 0.01) and a direct correlation of fibrosis with the ratio of P wave length to PR segment (r = .67 p = 0.01). There was a trend for percent fibrosis to correlate with PO wave duration but not height. No correlation was noted for any of the P wave characteristics and left atrial size. This study demonstrates that there is a correlation of P wave height with cell diameter and P wave length and PR segment with fibrosis. These data are helpful in understanding the electrocardiographic P wave.
本研究将左心耳细胞大小、心房纤维化以及左心房大小的超声心动图（回声）测量结果与P波形态相关联。12例已知二尖瓣疾病的患者接受了左心房大小的回声测量及P波形态分析。12例已知二尖瓣疾病的患者在二尖瓣手术前行左心房大小的回声测量；患者存在不同程度的左心房扩大。手术时切除的左心耳进行了纤维化百分比的体视学评估，并测量了50个细胞的直径并计算平均值。这些因素与II导联的P波振幅和时限、任何导联中的最大长度、PR段（P波终点至QRS波起点）、P波与PR段比值（II导联）以及PR间期相关。左心房细胞直径与P波振幅具有良好的相关性（r = 0.69，p = 0.01）。纤维化百分比与PR段呈良好的负相关（r = -0.72，p = 0.01），纤维化与P波长度与PR段比值呈正相关（r = 0.67，p = 0.01）。纤维化百分比有与P波时限相关但与高度无关的趋势。未发现任何P波特征与左心房大小之间存在相关性。本研究表明，P波高度与细胞直径相关，P波长度和PR段与纤维化相关。这些数据有助于理解心电图P波。
