The prognostic importance of isolated P-Wave abnormalities
Amir Kaykha1, Jonathan Myers, Kenneth B Desser
1Banner Good Samaritan Medical Center, Department of Cardiology, Phoenix, Arizona 85006, USA. akaykha@hotmail.com
Clinical Cardiology
|June 17, 2010
Summary
Electrocardiogram (ECG) P-wave amplitude predicts pulmonary death, while P-wave duration and inversion predict cardiovascular death. These simple ECG measurements aid in risk stratification for mortality.
Area of Science:
- Cardiology
- Pulmonology
- Medical Diagnostics
Background:
- P-wave morphologies on electrocardiograms (ECG) are linked to atrial size and cardiovascular (CV) or pulmonary disease.
- The association between P-wave characteristics and mortality, including cause of death, remains underreported.
Purpose of the Study:
- To investigate the predictive value of P-wave characteristics on ECG for pulmonary and CV mortality.
- To identify specific P-wave measurements that can serve as independent predictors of death.
Main Methods:
- Analysis of 40,020 digital ECGs from the Palo Alto Veterans Administration Medical Center.
- Utilized computerized algorithms to extract P-wave amplitude, duration, and standardized interpretations.
- Main outcome measures were pulmonary and CV mortality, analyzed using Cox regression.
Main Results:
- P-wave amplitude in inferior leads (>2.5 mm) was the strongest predictor of pulmonary death (HR: 3.0).
- P-wave duration and depth of P-wave inversion in V(1)/V(2) (>1 mm) strongly predicted CV death (HR: 1.7).
- These ECG findings outperformed established criteria for predicting mortality.
Conclusions:
- P-wave amplitude in inferior leads is a key independent predictor of pulmonary death.
- P-wave duration and inversion depth in V(1)/V(2) significantly predict CV death.
- These easily obtainable ECG measurements are valuable for clinical risk stratification.
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