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Relationship between abnormal P-wave terminal force in lead V1 and left ventricular diastolic dysfunction in

Michael T Tanoue1, Sverre E Kjeldsen2,3, Richard B Devereux1

  • 1a Greenberg Division of Cardiology , Weill Cornell Medical College , New York , NY , USA.

Blood Pressure
|September 8, 2016
PubMed

Insights

Abnormal P-wave terminal force in lead V1 (PTF-V1) indicates worse diastolic dysfunction in hypertensive patients. This ECG marker may help predict abnormal left ventricular diastolic behavior after blood pressure treatment.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Hypertension Management

Background:

  • Abnormal P-wave terminal force in lead V1 (PTF-V1) is an electrocardiogram (ECG) marker linked to left atrial (LA) abnormalities.
  • Left ventricular (LV) diastolic dysfunction can lead to LA remodeling, suggesting PTF-V1 might also indicate diastolic dysfunction.

Purpose of the Study:

  • To investigate if PTF-V1 is an additional ECG marker for left ventricular diastolic dysfunction.
  • To examine the relationship between baseline PTF-V1 and LV diastolic function after 3 years of antihypertensive treatment in hypertensive patients with preserved ejection fraction.

Main Methods:

  • 431 hypertensive patients with preserved LV ejection fraction (>45%) underwent 3 years of antihypertensive therapy.
  • Baseline and year-3 ECG and echocardiographic data were analyzed.
  • Abnormal diastolic function was defined using percentile values from a healthy control group; abnormal PTF-V1 was defined as a negative terminal P-wave in V1 ≥ 4000 μV·ms.

Main Results:

  • Abnormal PTF-V1 was associated with significantly worse diastolic function parameters at year 3, including longer filling times and altered mitral valve velocities (E/A ratio).
  • Multivariate analysis showed abnormal PTF-V1 significantly increased the odds of an abnormal mitral valve E/A ratio (OR 1.55) and trended towards higher odds of abnormal half filling time (OR 1.42).

Conclusions:

  • Abnormal P-wave terminal force in lead V1 is associated with impaired diastolic function in hypertensive patients.
  • PTF-V1 may serve as a predictor of abnormal left ventricular diastolic behavior following antihypertensive therapy in patients with preserved ejection fraction.
Abstract

Keywords:
Diastoleheart failurehypertensionhypertrophy

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