title: Dependence of P-wave dispersion on mean arterial pressure as an independent hemodynamic variable in school children.
abstract: BACKGROUND
  The relationship between diastolic dysfunction and P-wave dispersion (PWD) in the electrocardiogram has been studied for some time. In this regard, echocardiography is emerging as a diagnostic tool to improve risk stratification for mild hypertension.
  
  
  OBJECTIVE
  To determine the dependence of PWD on the electrocardiogram and on echocardiographic variables in a pediatric population.
  
  
  METHODS
  515 children from three elementary schools were studied from a total of 565 children. Those whose parents did not want them to take part in the study, as well as those with known congenital diseases, were excluded. Tests including 12-lead surface ECGs and 4 blood pressure (BP) measurements were performed. Maximum and minimum P-values were measured, and the PWD on the electrocardiogram was calculated. Echocardiography for structural measurements and the pulsed Doppler of mitral flow were also performed.
  
  
  RESULTS
  A significant correlation in statistical variables was found between PWD and mean BP for pre-hypertensive and hypertensive children, i.e., r = 0.32, p <0.01 and r = 0.33, p <0.01, respectively. There was a significant correlation found between PWD and the left atrial area (r = 0.45 and p <0.01).
  
  
  CONCLUSIONS
  We highlight the dependency between PWD, the electrocardiogram and mean blood pressure. We also draw attention to the dependence of PWD on the duration of the mitral inflow A-wave. This result provides an explanation for earlier changes in atrial electrophysiological and hemodynamic characteristics in pediatric patients.
authors.affiliation: Cardiocentro Ernesto Guevara de Villa Clara. Villa Clara, Cuba.
authors.forename: Elibet
authors.initials: E
authors.lastname: Chávez
authors.affiliation: Universidad Central de Las Villas. Villa Clara. Cuba.
authors.forename: Emilio F
authors.initials: EF
authors.lastname: González
authors.affiliation: Hospital Pediátrico Universitario José Luis Miranda. Villa Clara.Cuba.
authors.forename: María Del Carmen
authors.initials: Mdel C
authors.lastname: Llanes
authors.affiliation: Hospital Pediátrico Universitario José Luis Miranda. Villa Clara.Cuba.
authors.forename: Merlin Garí
authors.initials: MG
authors.lastname: Llanes
authors.affiliation: Hospital Pediátrico Universitario José Luis Miranda. Villa Clara.Cuba.
authors.forename: Yosvany
authors.initials: Y
authors.lastname: García
keywords: P-wave dispersion; blood hypertension; mitral A-wave duration; prehypertension