P wave dispersion is increased in pulmonary stenosis

Area of Science:

• Cardiology
• Electrophysiology
• Congenital Heart Disease

Background:

• Pulmonary stenosis (PS) is a congenital anomaly that increases right atrium pressure load.
• Increased atrial pressure can alter the atria's electrophysiological characteristics.
• Limited data exists on P wave dispersion (PWD) in patients with PS.

Purpose of the Study:

• To investigate P wave dispersion (PWD) in patients with valvular pulmonary stenosis (PS).
• To compare PWD and other electrocardiographic parameters between PS patients and healthy controls.
• To explore correlations between PWD, atrial dimensions, and the pressure gradient in PS.

Main Methods:

• Forty-two patients with valvular PS and 33 healthy controls were studied.
• Resting electrocardiography (ECG) was used to measure P wave duration, p wave maximum (p max), and p minimum (p min).
• Echocardiography assessed mean pressure gradient (MPG) at the pulmonary valve, valve structure, and atrial diameters.

Main Results:

• Patients with PS exhibited significantly higher p max (107.1 ± 11.5 ms vs. 98.2 ± 5.1 ms) and PWD (40.4 ± 1.2 ms vs. 27.2 ± 9.3 ms) compared to controls (p=0.01).
• The mean pressure gradient (MPG) was significantly higher in the PS group (43.11 ± 18.8 mmHg) than in controls (8.4 ± 4.5 mmHg).
• Right atrial diameter was significantly larger in the PS group (38.7 ± 3.9 mm vs. 30.2 ± 2.5 mm, p=0.02), and PWD correlated with the pressure gradient.

Conclusions:

• P wave dispersion and p max are elevated in individuals with pulmonary stenosis.
• PWD in PS is significantly correlated with the pressure gradient, reflecting the severity of the narrowing.
• No significant correlation was found between PWD and the diameters of the right or left atria.