title: Three dimensional left atrial volume index is correlated with P wave dispersion in elderly patients with sinus rhythm.
abstract: BACKGROUND
  P wave dispersion is a noninvasive electrocardiographic predictor for atrial fibrillation. The aim of the study was to explore relation between left atrial volume index assessed by 3-dimensional echocardiography and P wave dispersion in elderly patients.
  
  
  METHODS
  Seventy-three consecutive patients over the age of 65 (mean age: 75 ± 7 years, 17 men) were included. P wave dispersion is calculated as the difference between maximum and minimum P wave durations. Left atrial volume index was measured by both 2-dimensional and 3-dimensional echocardiography and categorized as normal (≤ 34 mL/m(2)) or increased (mild, 35-41 mL/m(2); moderate, 42-48 mL/m(2); severe, ≥ 49 mL/m(2)).
  
  
  RESULTS
  Thirty-one patients had normal left atrium while 24 patients had mildly enlarged, nine had moderately enlarged, and nine had severely enlarged left atrium. Prolongation of P wave dispersion was more prevalent in patients with dilated left atrium. P wave dispersion was significantly correlated with both 2-dimensional (r = 0.600, p < 0.001) and 3-dimensional left atrial volume index (r = 0.688, p < 0.001). Both left atrial volume indexes were associated with prolonged P wave dispersion when adjusted for age, sex, presence of hypertension, and left ventricular mass index. Receiver-operator characteristic (ROC) analysis revealed that a 3-dimensional left atrial volume index ≥ 25 mL/m(2) separated patients with prolonged P wave dispersion with a sensitivity of 82.2 %, specificity of 67.9 %, positive predictive value of 80.4 %, and negative predictive value of 70.4 %.
  
  
  CONCLUSIONS
  In elderly patients, 3-dimensional left atrial volume index showed a better correlation with P wave dispersion and might be helpful in discriminating patients with prolonged P wave dispersion, who might be prone to atrial fibrillation.
authors.affiliation: Department of Cardiology, American Hospital, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Ozyigit
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Sisli Etfal Teaching and Research Hospital, Istanbul, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Kocas
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Sisli Etfal Teaching and Research Hospital, Istanbul, Turkey.
authors.forename: Berrin
authors.initials: B
authors.lastname: Karadag
authors.affiliation: Department of Cardiology, Marmara University Faculty of Medicine, Yildiz Caddesi Konak Apartmani No: 43/16, 34353, Besiktas/Istanbul, Turkey. besteozben@yahoo.com.
authors.forename: Beste
authors.initials: B
authors.lastname: Ozben
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology*; D019560:Echocardiography, Three-Dimensional / Q000706:statistics & numerical data*; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006339:Heart Rate; D000070276:Heart Rate Determination / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009929:Organ Size; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014421:Turkey / Q000453:epidemiology
keywords: Echocardiography; Electrocardiography; Left atrial volume index; Left atrium; P wave dispersion