Abstract 12803: Abnormal P-wave Terminal Force in Lead V1 Is Associated with Cardiac Death or Hospitalization for Heart Failure in Prior Myocardial Infarction
The prognostic significance of P-wave terminal force in lead V1 (PTFV1), a marker of left atrial overload, has not been fully investigated in patients with myocardial infarction (MI). Accordingly, we sought to clarify the prognostic significance of PTFV1 in patients with prior MI. We retrospectively examined 185 patients with prior (> 6 months) MI. Patients with atrail fibrillation or flutter were excluded. The primary end point was cardiac death or hospitalization for heart failure. Abnormal PTFV1 was defined as PTFV1 ≥40 mm × msec. During a follow-up period of 6.4 ± 2.9 years, 39 patients developed the primary end point. A Kaplan-Meier analysis showed a lower primary event-free rate in 79 patients with abnormal PTFV1 than in 106 with normal PTFV1 (p <0.001) (figure). Univariate Cox regression analysis analyses showed that age, chronic kidney disease, multivessel coronary disease, anterior wall MI, left ventricular ejection fraction, number of leads with abnormal Q waves, abnormal PTFV1, loop diuretic use, and spironolactone use were significantly associated with the primary end point. A multivariate Cox regression analysis selected age (hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.04 - 1.14, p <0.001), multivessel coronary disease (HR 2.33, 95% CI 1.02 - 5.28, p = 0.04), and abnormal PTFV1 (HR 2.72, 95% CI 1.24 - 5.99, p = 0.01) as independent predictors of the primary end point. In conclusion, abnormal PTFV1 is an independent predictor of cardiac death or hospitalization for heart failure in patients with prior MI. The analysis of P waves in lead V1 would provide useful prognostic information in patients with prior MI.
- © 2012 by American Heart Association, Inc.