Relationship between P-wave dispersion, left ventricular mass index and function in Nigerian hypertensive patients
Francisca O Inofomoh1, Oluranti B Familoni1, Casmir E Amadi2
1Cardiology Unit, Department of Medicine, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
Insights
Hypertension is linked to prolonged P-wave dispersion (PWD), indicating irregular atrial electrical activity. This study found a higher prevalence of PWD in Nigerian hypertensive patients, suggesting potential risks for cardiovascular events.
Area of Science:
- Cardiology
- Electrophysiology
- Public Health
Background:
- Hypertension is a leading global cardiovascular disorder.
- Prolonged P-wave dispersion (PWD) is associated with atrial fibrillation, especially in hypertensive patients.
- Understanding PWD prevalence in diverse populations is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To determine the prevalence of PWD in Nigerian hypertensive patients.
- To investigate the relationship between PWD and left ventricular mass index and function in this population.
- To explore correlations between PWD and clinical parameters like waist circumference.
Main Methods:
- A study involving 150 hypertensive patients and control subjects.
- Measurement of P-wave dispersion (PWD) using electrocardiography (ECG).
- Assessment of left ventricular mass index and left ventricular function (ejection fraction and diastolic function).
Main Results:
- Mean PWD was significantly higher in hypertensive patients (38.29 ± 8.02 ms) compared to controls (32.14 ± 4.72 ms).
- 70% of hypertensive patients exhibited prolonged PWD (> 33.46 ms), compared to 32.7% of controls.
- Prolonged PWD showed a negative correlation with ejection fraction (r = -0.17, p = 0.03) but not with diastolic function. Waist circumference was the only significant difference between hypertensive patients with normal and prolonged PWD.
Conclusions:
- Prolonged PWD is prevalent in Nigerian hypertensive patients.
- PWD may serve as a marker for altered atrial conduction in hypertension.
- Further research is warranted to explore the clinical implications of PWD in hypertensive populations, particularly regarding cardiac function and atrial fibrillation risk.
Abstract:
Hypertension is the most prevalent cardiovascular disorder in the world. It is associated with target-organ damage in various organs and ECG changes. P-wave dispersion (PWD), which represents inhomogeneous atrial conduction and discontinuation of impulses, has been observed, when prolonged, to predict atrial fibrillation, particularly in the setting of hypertension. This study of PWD in 150 hypertensive patients and controls sought to determine the prevalence of PWD in Nigerian hypertensives and its relationship to left ventricular mass index and left ventricular function. Mean PWD in normal subjects was 32.14 ± 4.72 ms and was significantly shorter than that in hypertensive patients at 38.29 ± 8.02 ms. In the total population, 51.3% had prolonged PWD ( > 33.46 ms); 70% in the hypertensives and 32.7% of controls. The only significant difference in hypertensives with prolonged and normal PWD was the waist circumference. There was a negative correlation between PWD and ejection fraction (r = -0.17, p = 0.03), but not with diastolic function.
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