Relationship between P Wave Dispersion and Left Ventricular Diastolic Dysfunction in Hypertensive and Ischemic Heart Disease Patients.
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Date
2015
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Abstract
Background: There is growing recognition that congestive heart failure caused by a predominant
abnormality in left ventricular diastolic function is common and causes significant morbidity and
mortality. Diastolic function usually declines before systolic function, and this precedes clinical
signs. 12-lead electrocardiogram is a commonly used tool to assess left atrial enlargement, which is
a marker of left ventricular diastolic dysfunction. We investigated the relationship between P wave
dispersion, which is easily measured on the surface electrocardiogram and left ventricular diastolic
function.
Methods: There were 100 patients: 50 with diastolic dysfunction and 50 without. P wave dispersions
were calculated by measuring minimum and maximum P wave duration values on the surface
electrocardiogram. The relationships between P wave dispersion and echocardiographic measurements
of diastolic dysfunction were assessed.
Results: Maximum P wave duration was observed significantly (p=0.001) in patients with left
ventricular diastolic dysfunction (119.60±8.2 ms vs 114.0±6.4 ms). Minimum P wave duration was
observed significantly (p=0.001) higher in patients without diastolic dysfunction (72.6±7.5 ms vs
62.70±7.4 ms). P wave dispersion was observed significantly (p=0.001) higher in patients with left
ventricular diastolic dysfunction (56.6±6.3 ms vs 41.5±5.2 ms).
When patients were grouped according to grades of diastolic dysfunction, P wave dispersion was
observed sequentially increased among 3 grades of left ventricular diastolic dysfunction (55.8±5.2
ms vs 55.9±7.0 ms vs 61.4±4.7) but the differences were not statistically significant (p=0.09).
Conclusion: We conclude that P wave dispersion increases in diastolic dysfunction of LV. When
clinical and echocardiographic variables are taken into account, there is a weak but significant
correlation between P wave dispersion and left ventricular ejection fraction.
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Keywords
P wave, LV function, Diastolic function, Ischaemic heart disease, Hypertension
Citation
Tushar Asif Zaman, Majumder A A S, Azam S T M Abu, Ullah Mohammad, Ahmed Rashid, Saha Tapash, Islam, Rahman Md. Arifur. Relationship between P Wave Dispersion and Left Ventricular Diastolic Dysfunction in Hypertensive and Ischemic Heart Disease Patients. Cardiovascular Journal. 2015; 8(1): 13-18.