Electrocardiographic Left Atrial Abnormality and B-Type Natriuretic Peptide in a General Japanese Population: NIPPON...

P-wave terminal force in lead V₁ (PTFV₁) is an electrocardiogram marker of increased left atrial pressure and may be a noninvasive and early detectable marker for future cardiovascular events in the general population compared to serum B-type natriuretic peptide (BNP) concentration. The clinical significance of PTFV₁ in the contemporary general population is an area of unmet need. We aimed to demonstrate the correlation between PTFV₁ and BNP concentrations in a contemporary representative Japanese population.

Among 2,898 adult men and women from 300 randomly selected districts throughout Japan (NIPPON DATA2010), we analyzed 2,556 participants without cardiovascular disease (stroke, myocardial infarction, and atrial fibrillation). Elevated BNP was defined as a value of ≥ 20 pg/mL based on the definition from the Japanese Circulation Society guidelines.

In total, 125 (4.9%) participants had PTFV₁. Participants with PTFV₁ were older with a higher prevalence of hypertension, major electrocardiographic findings, and elevated BNP concentrations (13.5 [6.9, 22.8] versus 7.8 [4.4, 14.5] pg/mL; P＜0.001). After adjustment for confounders, PTFV₁ was correlated with elevated BNP (odds ratio, 1.66; 95% confidence interval, 1.05-2.62; P=0.030). This correlation was consistent among various subgroups and was particularly evident in those aged ＜65 years or those without a history of hypertension.

In the contemporary general population cohort, PTFV₁ was independently related to high BNP concentration. PTFV₁ may be an alternative marker to BNP in identifying individuals at a higher risk of future cardiovascular events in the East Asian population.