title: Association of P-Wave Dispersion with Overall and Cardiovascular Mortality in Hemodialysis Patients.
abstract: OBJECTIVE
  The P-wave parameters that are measured using a 12-lead electrocardiogram are commonly used as noninvasive tools for assessing left atrial enlargement. This study was designed to assess whether P-wave dispersion is associated with overall and cardiovascular mortality in hemodialysis patients.
  
  
  METHODS
  This study enrolled 209 hemodialysis patients. We measured the P-wave dispersion corrected by heart rate, that is, the corrected P-wave dispersion (PWdisperC), and assessed its correlation with overall and cardiovascular mortalities.
  
  
  RESULTS
  The mean PWdisperC of all the patients was 93.3 ± 21.1 ms. During the follow-up period (mean 5.4 years), 58 deaths and 37 cardiovascular deaths were recorded. The adjusted value of PWdisperC was also associated with overall (hazards ratio (HR) 1.018, 95% CI 1.004-1.033, p = 0.014) and cardiovascular (HR 1.032, 95% CI 1.012-1.053, p = 0.002) mortalities. Multivariate Cox regression analysis identified tertile 3 of PWdisperC (vs. tertile 1) to be associated with overall (HR 2.472, 95% CI 1.181-5.174, p = 0.016) and cardiovascular (HR 3.896, 95% CI 1.463-10.376, p = 0.007) mortalities, after adjustment for demographic, clinical and biochemical parameters. Adding PWdisperC to a model of clinical features could significantly improve the predictive value for overall (p = 0.044) and cardiovascular (p = 0.002) mortalities.
  
  
  CONCLUSIONS
  We concluded that PWdisperC was positively associated with overall and cardiovascular mortalities in hemodialysis patients and could provide additional prognostic values. Screening hemodialysis patients by using PWdisperC may facilitate identifying a group of patients with poor prognosis.
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Chen
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Jiun-Chi
authors.initials: JC
authors.lastname: Huang
authors.forename: Ko
authors.initials: K
authors.lastname: Chang
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Tsai
authors.forename: Ling-I
authors.initials: LI
authors.lastname: Chen
authors.forename: Jer-Ming
authors.initials: JM
authors.lastname: Chang
authors.forename: Shang-Jyh
authors.initials: SJ
authors.lastname: Hwang
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D013624:Taiwan / Q000453:epidemiology