Abstract 12206: P-Wave Morphologic Characteristics of 12-Lead Surface Electrocardiography Were Associated With Left Ventricular Diastolic Dysfunction
Introduction: Left ventricular diastolic dysfunction was demonstrated to be an early stage of heart failure, but the association between diastolic dysfunction and the P-wave morphology of 12-lead surface electrocardiography (ECG) has been unclear.
Hypothesis: We assessed the hypothesis that the P-wave morphologic characteristics of 12-lead surface ECG were associated with diastolic dysfunction.
Methods: We enrolled 1,256 patients who had at least one cardiovascular risk factor (hypertension, dyslipidemia, diabetes, or smoking). Their P-wave morphology on ECG was classified as normal (n=731), deflected (n=299), and notched type (n=226) in limb leads. P-wave morphology was defined as “deflected” if the ECG presented a deviation from a smooth fluent wave without showing a clear bifid pattern, and as “notched” if the peak-to-peak distance in the M-shape was more than 40 msec. We examined echocardiography and brain natriuretic peptide (BNP), and obtained an ECG in all patients.
Results: Patients with notched P had significantly lower amplitudes of E-wave (60.5±17.0 vs. 66.8±16.9 cm/s, p<0.001), lower E/A ratios (0.80±0.25 vs. 0.90±0.39, p<0.001), and higher BNP levels (median: 20.3 vs. 16.8 pg/dL, p<0.001) compared to the patients with normal P-waves. After adjusting for age and gender, notched P was an independent factor of lower E/A (p=0.019) and higher BNP (p=0.03). The left atrial diameter and the amplitude of the A-wave were similar among the three subgroups.
Conclusions: Notched P-wave was associated with diastolic dysfunction, but not with left atrial diameter. P-wave morphologic characteristics might be a reflection of diastolic dysfunction.
Author Disclosures: T. Kabutoya: None. S. Hoshide: None. K. Eguchi: None. K. Kario: None.
- © 2014 by American Heart Association, Inc.