title: Are maximum P wave duration and P wave dispersion a marker of target organ damage in the hypertensive population?
abstract: BACKGROUND
  High blood pressure, left ventricular hypertrophy and diastolic dysfunction may cause hemodynamic and morphological changes in the left atrium, consequently instability and heterogeneity in atrial conduction. This is seen as an increase in maximum P wave duration (P(max)) and P wave dispersion (PD) on the electrocardiogram (ECG). P wave dispersion on ECG has been encountered as a risk factor for atrial fibrillation (AF). The aim of this study is to examine whether PD and P(max) can be used as a non-invasive marker of target organ damage (LVH and diastolic dysfunction) in a hypertensive population.
  
  
  METHODS
  The study registered a total of 120 cases (mean age 46.9 +/- 10.6 years; 58 [48.3%] males and 62 [51.7%] females), of whom 60 were patients diagnosed as essential hypertension (group 1), and 60 were healthy individuals, who constituted the control group (group 2). Systolic and diastolic functions of all cases were evaluated by echocardiography, and maximum P wave duration (P(max)), and PD was calculated.
  
  
  RESULTS
  Maximum P wave duration was 91.6 +/- 10.2 ms in group 1, and 64 +/- 10.2 ms in group 2 (p < 0.01), while PD was 56.1 +/- 5.8 ms in group 1, and 30.3 +/- 6.6 ms in group 2 (p < 0.01). Blood pressure, left atrium diameter, DT, IVRT, and E/A ratio, as well as left ventricular mass index increased markedly in group 1.
  
  
  CONCLUSIONS
  High blood pressure, LVH, diastolic dysfunction and increased left atrium diameter and volume shows parallelism in hypertensive cases. These physiopathological changes may cause different and heterogeneous atrial electrical conduction. This led to a marked increase in P(max) and PD in our cases. Thus, the results support the hypothesis that PD can be used as a non-invasive marker of target organ damage (LVH and LV diastolic dysfunction) in the hypertension population.
authors.affiliation: Firat Universitesi, Elazig, Turkey. mustafanecati46@hotmail.com
authors.forename: Necati
authors.initials: N
authors.lastname: Dagli
authors.forename: Ilgin
authors.initials: I
authors.lastname: Karaca
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yavuzkir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Balin
authors.forename: Nadi
authors.initials: N
authors.lastname: Arslan
mesh_terms: D000328:Adult; D015415:Biomarkers; D001795:Blood Pressure Determination / Q000379:methods; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D018450:Disease Progression; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D054143:Heart Failure, Systolic / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis
chemical_list: D015415:Biomarkers