title: Evaluation of the prognostic value of electrocardiography parameters and heart rhythm in patients with pulmonary hypertension.
abstract: BACKGROUND
  Several studies have analyzed arrhythmias in patients with pulmonary hypertension (PH) and increased P-wave duration was identified as a risk factor for development of atrial fibrillation (AF).
  
  
  METHODS
  We retrospectively analyzed the incidence of arrhythmias in patients with an initial diagnosis of PH during long-term follow-up and assessed the prognostic value of electrocardiography (ECG) data. Data from 167 patients were analyzed (Dana Point Classification: Group 1: 59 patients, Group 2: 28 patients, Group 3: 39 patients, Group 4: 41 patients). Clinical, 6-min-ute walk distance test, echocardiography and right heart catheterization data were collected, and baseline/follow-up ECGs were analyzed.
  
  
  RESULTS
  Baseline ECGs revealed sinus rhythm in 137 patients. Thirteen patients had newly onset AF during follow-up. In 30 patients, baseline ECG showed AF. Patients with baseline AF showed higher atrial diameters and higher right atrial pressure. Patients with P-wave du-ration > 0.11 s had shorter survival. Other ECG parameters (PQ-interval, QRS-width, QT-/ /QTc-interval) were not associated with survival. Mean survival times were 79.4 ± 5.4 months (sinus rhythm), 64.4 ± 12.9 months (baseline AF) and 58.8 ± 8.9 months (newly onset AF during follow-up) (p = 0.565).
  
  
  CONCLUSIONS
  Atrial fibrillation predict adverse prognosis in patients with PH and a longer P-wave (> 0.11 s) is associated with shorter survival time.
authors.affiliation: University of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany. dirk.bandorski@hkw.med.uni-giessen.de.
authors.forename: Dirk
authors.initials: D
authors.lastname: Bandorski
authors.forename: Harilaos
authors.initials: H
authors.lastname: Bogossian
authors.forename: Anja
authors.initials: A
authors.lastname: Ecke
authors.forename: Christoph
authors.initials: C
authors.lastname: Wiedenroth
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Gruenig
authors.forename: Nicola
authors.initials: N
authors.lastname: Benjamin
authors.forename: Matthias
authors.initials: M
authors.lastname: Arlt
authors.forename: Werner
authors.initials: W
authors.lastname: Seeger
authors.forename: Eckhard
authors.initials: E
authors.lastname: Mayer
authors.forename: Ardeschir
authors.initials: A
authors.lastname: Ghofrani
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hoeltgen
authors.forename: Henning
authors.initials: H
authors.lastname: Gall
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005858:Germany / Q000453:epidemiology; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
keywords: arrhythmia; atrial fibrillation; electrocardiogram; pulmonary hypertension