title: P wave analysis and left ventricular systolic function in chronic heart failure. Possible insights form the P wave - PP interval spectral coherence.
abstract: Chronic increase in left ventricular filling pressure represents one of the most important mechanism underlying the structural, as well as the electrical, atrial chamber remodeling leading to atrial fibrillation. The present pilot pathophysiological study sought to investigate possible relationship between short-period cross-spectral coherence of P-Q, R-R and P-P intervals and echocardiographic indices of left ventricular and atrial function.
  
  
  
  Electrocardiographic single lead short-term cross-spectral analysis on P-Q and P-P intervals was performed in 31 patients with chronic heart failure (CHF). Twenty age and therapy matched hypertensive patients acted as control group. The interval between the beginning of P wave and its peak (Ppeak) was also analyzed.
  
  
  
  Patients with CHF showed a significant lower PQ → PP and Ppeak → PP coherence (P<0.001) than the counterpart. At multivariate analysis only Ppeak → PP was independently associated to LVEF (r2:0.312; b:60; β:0.559; P<0.0001) and atrial volume (r2:-0.160; b:-0.15; β:-0.400, P<0.05).
  
  
  
  Ppeak → PP coherence might be a simple marker of left ventricular and atrial function. Whether this index could be a useful noninvasive marker of increased left ventricular filling pressure and, possibly, of atrial fibrillation risk or not, it needs to be tested in larger prospective studies.
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiology and Geriatric Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy - gianfranco.piccirillo@uniroma1.it.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Piccirillo
authors.forename: Federica
authors.initials: F
authors.lastname: Moscucci
authors.forename: Claudia
authors.initials: C
authors.lastname: Fiorucci
authors.forename: Gaetana
authors.initials: G
authors.lastname: D'Alessandro
authors.forename: Matteo
authors.initials: M
authors.lastname: Pascucci
authors.forename: Damiano
authors.initials: D
authors.lastname: Magrì
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology; D002908:Chronic Disease; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D018570:Risk Assessment; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology