The relationship between the left atrial volume and the maximum P-wave and P-wave dispersion in patients with congestive heart failure.
OBJECTIVE
A maximum P-wave duration (Pmax) of > or = 110 msec and a P-wave dispersion (PWD) > or = 40 msec are accepted indicators of a disturbance in interatrial conduction and an inhomogeneous propagation of the sinus impulse, respectively. The left atrial (LA) volume has been reported to be strongly associated with a systolic and diastolic dysfunction and is considered to be an index of atrial remodeling. We aimed to investigate the relationship between LA volume and Pmax or PWD in patients with congestive heart failure (CHF).


METHODS
Sixty-one patients with CHF were enrolled in this study. The study population was classified into four groups: two groups were divided according to the Pmax (> or = 110 msec or < 110 ms), and the other two groups were formed based on the PWD (> or = 40 msec or < 40 msec). The left atrial volume index (LAVi) was measured by three-dimensional (3-D) transthoracic echocardiography. The Pmax and PWD were measured from a 12-lead electrocardiogram.


RESULTS
There were significant differences in the ejection fraction (EF), diastolic function, and LAVi between patients with a Pmax > or = 110 ms or a PWD > or = 40 ms and those with a Pmax < 110 ms or a PWD < 40 ms. The LAVi was independently associated with a disturbance in interatrial conduction and an inhomogeneous propagation of the sinus impulse. The LAVi can be used to identify patients with a disturbance in interatrial conduction and an inhomogeneous propagation of the sinus impulse with reasonably good accuracy.


CONCLUSIONS
We concluded that a disturbance in interatrial conduction and an inhomogeneous propagation of the sinus impulse in patients with CHF is associated with an increase in the LA volume and a deleterious systolic and diastolic dysfunction.
Kim
Dae-Hyeok
DH
Department of Cardiology, Inha University College of Medicine, 7-206 3ga, Sinheung-dong, Jung-gu, Incheon 400-711, Korea. kdhmd@korea.com
Kim
Gi-Chang
GC
Kim
Soo-Hyun
SH
Yu
Hyung-Kwon
HK
Choi
Woong-Gil
WG
An
In-Sun
IS
Kwan
Jun
J
Park
Keum-Soo
KS
Lee
Woo-Hyung
WH
D000368:Aged; D016279:Atrial Function, Left; D002306:Cardiac Volume; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054138:Sinus Arrest, Cardiac / Q000000981:diagnostic imaging