title: C-reactive protein and P-wave in hypertensive patients after conversion of atrial fibrillation.
abstract: OBJECTIVE
  P maximum/P dispersion and high-sensitivity C-reactive protein (hs-C-reactive protein) have been proposed as useful markers for predicting the history and recurrence of atrial fibrillation. We tested the association between hs-C-reactive protein and maximum P-wave duration (P maximum)/P-wave dispersion (P dispersion) in hypertensive patients after conversion of atrial fibrillation.
  
  
  METHODS
  We enrolled 92 patients. Hs-C-reactive protein was assessed before cardioversion, the 12-lead ECG was recorded immediately after sinus rhythm restoration.
  
  
  RESULTS
  At univariate analysis P maximum above 120  ms was associated with male sex (P = 0.0009), body mass index at least 25  kg/m (P = 0.03) and hs-C-reactive protein greater than 0.30  mg/dl (P = 0.0001), and left atrium diameter greater than 40 mm nearly significant (P = 0.05). P dispersion above 40  ms was associated with hs-C-reactive protein greater than 0.30  mg/dl (P = 0.0001) and left atrium diameter greater than 0.40  mm (P = 0.03). P maximum/P dispersion (mean ± SD) was significantly longer in patients with hs-C-reactive protein greater than 0.30  mg/dl compared to patients with hs-C-reactive protein 0.30  mg/dl or less (P = 0.0001 for both). At multivariate analysis P maximum above 120  ms was associated with male sex (P = 0.01) and with hs-C-reactive protein greater than 0.30  mg/dl (P = 0.002), whereas P dispersion above 40  ms was associated only with hs-C-reactive protein greater than 0.30  mg/dl (P = 0.0006).
  
  
  CONCLUSIONS
  Male sex and hs-C-reactive protein were associated with P maximum above 120  ms; hs-C-reactive protein was also associated with P dispersion above 40  ms in hypertensive patients after conversion of atrial fibrillation. Subclinical inflammation may be associated with delayed/inhomogeneous atrial activation in hypertensive patients affected by atrial fibrillation.
authors.affiliation: Cardiology Division, Santa Maria della Stella Hospital, Orvieto, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mazza
authors.forename: Maria G
authors.initials: MG
authors.lastname: Bendini
authors.forename: Marco
authors.initials: M
authors.lastname: Cristofori
authors.forename: Massimo
authors.initials: M
authors.lastname: Leggio
authors.forename: Stefano
authors.initials: S
authors.lastname: Nardi
authors.forename: Andrea
authors.initials: A
authors.lastname: Giordano
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Cristofaro
authors.forename: Giampiero
authors.initials: G
authors.lastname: Giordano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000378:metabolism / Q000503:physiopathology*; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000378:metabolism / Q000503:physiopathology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein