Electrocardiographic diagnosis of left atrial enlargement in patients with mitral stenosis: the value of the P-wave area.
OBJECTIVE
To investigate the value of the P-wave area in diagnosing left atrial enlargement in patients with mitral stenosis.


METHODS
We measured the P-wave area from lead II of a standard 12-lead ECG in 136 consecutive patients with mitral stenosis. We also measured the left atrial diameter with two-dimensional echocardiography.


RESULTS
Left atrial enlargement was identified in 120 (88.2%) patients. There was an excellent correlation between P-wave area and left atrial diameter in these patients (r = 0.739, p = 0.001). A P-wave area of > or = 4 ms x mv had an 85.8% sensitivity and 93.7% specificity for left atrial enlargement. There was also a smaller but significant correlation between left atrial diameter and the total P-wave duration (r = 0.635, p < 0.01) or P-wave amplitude (r = 0.683, p < 0.01) in these patients. However, the P-wave area had a better overall sensitivity than the P-wave duration (43.3%) or amplitude (10.8%) in diagnosing left atrial enlargement.


CONCLUSIONS
Left atrium enlargement can be estimated by P-wave area measured from ECG lead II in patients with mitral stenosis. A P-wave area 24 ms x mv serves as a new criterion of left atrial enlargement.
Zeng
Chunlai
C
Department of Cardiology, Lishui City Central Hospital, Zhejiang Province, People's Republic of China.
Wei
Tiemin
T
Zhao
Ruiying
R
Wang
Chunming
C
Chen
Liping
L
Wang
Lexin
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D006332:Cardiomegaly / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000503:physiopathology