Predictive value of P wave parameters, indices, and a novel electrocardiographic marker for silent cerebral infarction and future cerebrovascular events.

Autor: Cagdas M; Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey., Celik AI; Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey. Electronic address: azizinanmd@hotmail.com., Bezgin T; Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey., Baytugan NZ; Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey., Dagli M; Department of Cardiovascular Surgery, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey., Zengin A; Department of Cardiovascular Surgery, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey., Ozmen C; Department of Cardiology, Faculty of Medicine, Cukurova University, Adana, Turkey., Karakoyun S; Department of Cardiology, Akademi Hospital, Kocaeli, Turkey; Faculty of Health Sciences, Kocaeli Health and Technology University, Kocaeli, Turkey.
Jazyk: angličtina
Zdroj: Journal of electrocardiology [J Electrocardiol] 2023 Nov-Dec; Vol. 81, pp. 186-192. Date of Electronic Publication: 2023 Sep 21.
DOI: 10.1016/j.jelectrocard.2023.09.004
Abstrakt: Background: Silent cerebral infarction (SCI) is a neuronal injury without a clinically apparent stroke or transient ischaemic attack. Left atrial cardiomyopathy is closely associated with SCI. P wave changes in the electrocardiogram (ECG) provide significant information about the development of atrial cardiomyopathy. This study evaluated the role of P wave parameters and indices and a novel ECG parameter in predicting SCI, future cerebrovascular events, and atrial fibrillation/flutter.
Materials and Methods: A total of 272 patients were retrospectively screened and divided into two groups according to SCI. Cerebrovascular events and atrial fibrillation/flutter were defined as the study's outcomes. P wave parameters, indices, and a novel ECG parameter called the P wave ratio (PWR) were calculated from ECGs, and the relationship between SCI and outcomes was investigated.
Results: The maximum P wave duration (PWD), P wave dispersion (PWdisp), PWD measured from the D2 lead (PWDD2), P wave peak time measured from the D2 lead (PWPTD2), PWPT measured from the V1 lead (PWPTV1), and P wave terminal force (PWTFV1) were significantly longer in the SCI group. Both partial and advanced inter atrial block (IAB) were significantly high in the SCI group. The novel parameter P wave ratio (PWR) was significantly longer in the SCI group (0.55 ± 0.08 vs. 0.46 ± 0.09; p < 0.001). In multivariate regression analysis, PWdisp (OR: 1.101, p < 0.001), PWPTD2 (OR: 1.095, p = 0.017), and PWR (OR: 1.231, p < 0.001) were found to be independent predictors of SCI. Cox regression analysis revealed that the PWR (HR 1.077; 95% CI 1.029-1.128; p = 0.001) was associated with cerebrovascular events and atrial fibrillation/flutter.
Conclusion: In our study, we observed that PWR could be a valuable parameter for predicting SCI and future cerebrovascular events.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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