The effects of iron deficiency anemia on p wave duration and dispersion.
OBJECTIVE
The association between P wave dispersion and iron deficiency anemia has not been documented in the literature. In this study, we evaluated P wave dispersion in patients with iron deficiency anemia and the possible relationships between P wave dispersion and other echocardiographic parameters.


BACKGROUND
The iron status of an individual may play an important role in cardiovascular health. Anemia is an independent risk factor for adverse cardiovascular outcomes. P wave dispersion is a simple electrocardiographic marker that has a predictive value for the development of atrial fibrillation. Apart from cardiovascular diseases, several conditions, such as seasonal variation, alcohol intake and caffeine ingestion, have been demonstrated to affect P wave dispersion.


METHODS
The study included 97 patients who had iron deficiency anemia and 50 healthy subjects. The cases were evaluated with a clinical examination and diagnostic tests that included 12-lead electrocardiography and transthoracic echocardiography.


RESULTS
Compared to the control group, patients with iron deficiency anemia showed significantly longer maximum P wave duration (Pmax) (91.1 ± 18.0 vs. 85.8 ± 6.7 msec, p = 0.054), P wave dispersion (PWD) (48.1 ± 7.7 vs. 40.9 ± 5.6 msec, p < 0.001), mitral inflow deceleration time (DT) (197.5 ± 27.9 vs. 178.8 ± 8.9 msec, p < 0.001) and isovolumetric relaxation time (IVRT) (93.3 ± 9.2 vs. 77.4 ± 8.2 msec, p < 0.001); they also showed increased heart rate (85.7 ± 16.1 vs. 69.0 ± 4.4, p < 0.001) and frequency of diastolic dysfunction (7 (7.2%) vs. 0). Correlation analysis revealed that PWD was significantly correlated with IVRT, DT, heart rate, the presence of anemia and hemoglobin level.


CONCLUSIONS
Iron deficiency anemia may be associated with prolonged P wave duration and dispersion and impaired diastolic left ventricular filling.
Cardiology Department, Faculty of Medicine, Yuzuncu Yil University, Turkey.
Hakki
H
Simsek
Yilmaz
Y
Gunes
Cengiz
C
Demir
Musa
M
Sahin
Hasan Ali
HA
Gumrukcuoglu
Mustafa
M
Tuncer
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D054144:Heart Failure, Diastolic / Q000209:etiology / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D018709:Statistics, Nonparametric
D006454:Hemoglobins
Nephrol Dial Transplant. 2000;15 Suppl 3:14-8
11032352
Clin Invest Med. 1991 Dec;14(6):614-22
1665406
Am Heart J. 1998 May;135(5 Pt 1):733-8
9588401
Pacing Clin Electrophysiol. 2000 Jul;23(7):1109-12
10914366
Am J Cardiol. 1989 Jul 15;64(3):222-4
2525871
Int J Obes (Lond). 2006 Jun;30(6):957-61
16432544
Circulation. 2001 May 29;103(21):E111-1
11382743
Tohoku J Exp Med. 2007 Aug;212(4):397-402
17660705
BMC Physiol. 2002;2:1
11818034
Pacing Clin Electrophysiol. 2003 Jan;26(1P2):367-72
12687847
Am J Kidney Dis. 1996 Jul;28(1):53-61
8712222
Nephrol Dial Transplant. 2002;17 Suppl 1:3-7
11812905
Indian Heart J. 1991 Mar-Apr;43(2):105-8
1752610
Tohoku J Exp Med. 2005 Oct;207(2):165-70
16141686
Tex Heart Inst J. 2005;32(2):163-7
16107107
Am J Hypertens. 1998 May;11(5):539-47
9633789
J Am Coll Cardiol. 2002 Jul 3;40(1):27-33
12103252
J Am Soc Echocardiogr. 2005 Dec;18(12):1440-63
16376782
J Am Coll Cardiol. 1987 Oct;10(4):748-55
2958530
J Am Coll Cardiol. 1995 Aug;26(2):497-502
7608455
Proc Soc Exp Biol Med. 1990 Apr;193(4):306-12
2320600
Anadolu Kardiyol Derg. 2005 Dec;5(4):289-93
16330394
Pacing Clin Electrophysiol. 2008 Jul;31(7):889-92
18684287
N Engl J Med. 1999 Aug 19;341(8):577-85
10451464
J Electrocardiol. 2002 Oct;35(4):307-11
12395357
Anadolu Kardiyol Derg. 2007 Sep;7(3):310-5
17785223
Card Electrophysiol Rev. 2002 Sep;6(3):215-20
12114841
Heart Fail Rev. 2000 Mar;5(1):45-56
16228915
J Clin Pharm Ther. 2001 Apr;26(2):145-8
11350538
Am Heart J. 1972 Mar;83(3):415-26
4551028
Circulation. 2003 Oct 28;108(17):2154-69
14581387
Eur Heart J. 1998 Jul;19(7):990-1003
9717033