title: P-wave dispersion: relationship to left ventricular function in sickle cell anaemia.
abstract: BACKGROUND
  The prognostic implications of P-wave dispersion in patients with a variety of cardiac disease conditions are increasingly being recognised. The relationship between P-wave dispersion and left ventricular function in sickle cell anaemia is unknown.
  
  
  OBJECTIVE
  This study was aimed at evaluating the relationship between P-wave dispersion and left ventricular function in adult Nigerian sickle cell anaemia patients.
  
  
  METHODS
  Between February and August 2007, a total of 62 sickle cell anaemia patients (aged 18-44 years; mean 28.27 ± 5.58) enrolled in the study. These were drawn from patients attending the adult sickle cell clinic of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu. An equal number of age- and gender-matched normal subjects served as controls. All the participants were evaluated with electrocardiography and echocardiography. P-wave dispersion was defined as the difference between the maximum and minimum P-wave duration measured in a 12-lead electrocardiogram.
  
  
  RESULTS
  P-wave duration and P-wave dispersion were significantly higher in patients than in controls. Significant correlation was demonstrated between P-wave dispersion and age in the patients (r = 0.387; p = 0.031). A comparison of subsets of sickle cell anaemia patients and controls with comparable haematocrit values (30-35%) showed significantly higher P-wave duration and P-wave dispersion in the patients than in the controls. The P-wave duration in patients and controls, respectively, was 111.10 ± 14.53 ms and 89.14 ± 16.45 ms (t = 3.141; p = 0.006). P-wave dispersion was 64.44 ± 15.86 ms in the patients and 36.43 ± 10.35 ms in the controls (t = 2.752; p = 0.013). Significant negative correlation was found between P-wave dispersion and left ventricular transmitral E/A ratio (r = -0.289; p = 0.023).
  
  
  CONCLUSIONS
  These findings suggest that P-wave dispersion could be useful in the evaluation of sickle cell patients with left ventricular diastolic dysfunction. Further prospective studies are recommended to evaluate its prognostic implication on the long-term disease outcome in sickle cell disease patients.
authors.affiliation: Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria. nelifyik@yahoo.com
authors.forename: N I
authors.initials: NI
authors.lastname: Oguanobi
authors.forename: B J
authors.initials: BJ
authors.lastname: Onwubere
authors.forename: S O
authors.initials: SO
authors.lastname: Ike
authors.forename: B C
authors.initials: BC
authors.lastname: Anisiuba
authors.forename: E C
authors.initials: EC
authors.lastname: Ejim
authors.forename: O G
authors.initials: OG
authors.lastname: Ibegbulam
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006400:Hematocrit; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult