title: P-wave dispersion and maximum duration are independently associated with insulin resistance in metabolic syndrome.
abstract: BACKGROUND
  Metabolic syndrome (MS) is an important risk factor for atrial fibrillation. P-wave indices, including P-wave dispersion (PWD) and P-wave duration, can be used as non-invasive markers of heterogeneous atrial conduction. The aim of our study was to evaluate the relationship between P-wave indices and insulin resistance in patients with MS.
  
  
  METHODS
  Seventy-four patients with MS (44 men, 30 women) and 81 patients without MS (48 men, 33 women) were enrolled in the study. A diagnosis of MS was made as defined by the Adult Treatment Panel III of the National Cholesterol Education Program. Insulin resistance was estimated using the homeostasis model assessment (HOMA) index. P-wave maximum duration (Pmax) and P-wave minimum duration (Pmin) were calculated on a 12-lead electrocardiogram, and the difference between the Pmax and the Pmin was defined as PWD.
  
  
  RESULTS
  Patients with MS had a longer PWD and a higher Pmax compared with patients without MS (PWD, 35.65±4.36 vs. 26.27±4.04, P<0.001; Pmax, 117.12±10.77 vs. 105.98±9.02, P<0.001), whereas no difference was found between Pmin values from MS patients and controls (81.47±9.54 vs. 79.70±8.76, P=0.231). Stepwise multivariate analysis revealed only the HOMA index to be an independent predictor of PWD (β=3.115, P<0.001) and Pmax (β=7.175, P<0.001).
  
  
  CONCLUSIONS
  This study suggests that patients with MS have a prolonged PWD and Pmax. The increase in these parameters may be an indicator for identification of patients at an increased risk for atrial fibrillation.
authors.affiliation: Union Hospital, Union Clinic Medical College, Fujian Medical University, Fuzhou, People's Republic of China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Union Hospital, Union Clinic Medical College, Fujian Medical University, Fuzhou, People's Republic of China.
authors.forename: Feilong
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Union Hospital, Union Clinic Medical College, Fujian Medical University, Fuzhou, People's Republic of China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Xhen
authors.affiliation: Union Hospital, Union Clinic Medical College, Fujian Medical University, Fuzhou, People's Republic of China.
authors.forename: Xuehai
authors.initials: X
authors.lastname: Chen
authors.affiliation: Union Hospital, Union Clinic Medical College, Fujian Medical University, Fuzhou, People's Republic of China.
authors.forename: Fayuan
authors.initials: F
authors.lastname: Fu
authors.affiliation: Union Hospital, Union Clinic Medical College, Fujian Medical University, Fuzhou, People's Republic of China.
authors.forename: Mirong
authors.initials: M
authors.lastname: Tang
authors.affiliation: Union Hospital, Union Clinic Medical College, Fujian Medical University, Fuzhou, People's Republic of China. Electronic address: lianglongchenxhyy@126.com.
authors.forename: Lianglong
authors.initials: L
authors.lastname: Chen
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000209:etiology; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004452:Echocardiography; D004562:Electrocardiography; D005215:Fasting; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose
keywords: Atrial conduction; Conduction auriculaire; Dispersion des ondes P; Insulin resistance; Metabolic syndrome; P-wave dispersion; Résistance à l’insuline; Syndrome métabolique