Anxiety and P wave dispersion in a healthy young population.
BACKGROUND
P wave dispersion (P(d)), defined as the difference between the maximum (P(max)) and the minimum P wave duration (P(min)), and P(max) are electrocardiographic (ECG) markers that have been used to evaluate the discontinuous propagation of sinus impulses and the prolongation of atrial conduction time. P(d) in normal subjects has been reported to be influenced by the autonomic tone, which induces changes in atrial size and the velocity of impulse propagation. However, the association between P(d) and anxiety has not been studied in normal subjects.


RESULTS
P(max), P(min) and P(d) were measured in 726 physically and mentally healthy young male volunteers, aged 21.23 +/- 1.25 years (range 20-26). The Spielberger State-Trait Anxiety Inventory (STAI) was scored concomitantly. Blinded intra- and interobserver reproducibility of the P wave duration and P(d) measurement were evaluated, and comparison revealed a Pearson correlation coefficient of 0.87 and 0.89 for the P wave duration, and 0.93 and 0.90 for P(d), respectively (p < 0.001). P(max) and P(d) were significantly correlated with the state anxiety (STAI-1) subscale (r = 0.662, p < 0.001, and r = 0.540, p < 0.001, respectively) and the trait anxiety (STAI-2) subscale (r = 0.583, p < 0.001, and r = 0.479, p < 0.001, respectively). P(min) did not show any significant correlation with anxiety. Across 3 variables included in a multiple linear regression analysis, STAI-1 and STAI-2 were the significant independent determinants of P(max) and P(d). Beta coefficients indicated that the contribution of STAI-1 to P(max) (66.3 and 33.7%) and P(d) (65 and 35%) was much greater than that of STAI-2.


CONCLUSIONS
STAI-1 and STAI-2 are associated with an increase in P(max) and P(d). The association of P(d) resulted from an augmentation of P(max). This is the first study to show the relation between P(max), P(d) and anxiety.
Uyarel
Huseyin
H
Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey. uyarel@yahoo.com
Kasikcioglu
Hulya
H
Dayi
Sennur Unal
SU
Tartan
Zeynep
Z
Karabulut
Ahmet
A
Uzunlar
Bulent
B
Samur
Hasan
H
Sari
Ibrahim
I
Okmen
Ertan
E
Cam
Nese
N
D000328:Adult; D001007:Anxiety / Q000503:physiopathology*; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results; D013223:Statistics as Topic