Prognostic value of P-wave morphology in general population

Area of Science:

• Cardiology
• Electrocardiography
• Public Health

Background:

• P-wave morphology on electrocardiograms (ECGs) provides insights into atrial electrical activity.
• Previous research has linked certain P-wave abnormalities to cardiovascular disease, but novel descriptors require further investigation for prognostic value.

Purpose of the Study:

• To assess the prognostic significance of novel P-wave morphology characteristics in predicting mortality risk within a general population sample.
• To determine if specific P-wave descriptors are independently associated with sudden cardiac death (SCD), non-SCD, or non-cardiac death (NCD).

Main Methods:

• Utilized digitized ECGs from 6906 middle-aged individuals in the Mini-Finland Health Survey.
• Analyzed novel P-wave morphology variables, including P-wave dispersion (PMD) and P-wave maximum amplitude (P-MaxAmp-Z), using custom software.
• Employed Cox multivariate hazards models to adjust for potential confounders and assess mortality prediction.

Main Results:

• Most P-wave morphology parameters showed significant univariate associations with all cause mortality.
• After multivariate adjustments, P-wave dispersion (PMD) showed a trend towards predicting SCD (HR: 1.006, P=0.05) but not NSCD or NCD.
• P-wave maximum amplitude in lead Z (P-MaxAmp-Z) independently predicted SCD (HR: 1.010, P=0.0002), NSCD (HR: 1.005, P=0.0005), and NCD (HR: 1.002, P=0.03).

Conclusions:

• Abnormal P-wave morphology is linked to increased risk of various death modes in the general population.
• P-wave maximum amplitude (P-MaxAmp-Z) is a significant independent predictor of SCD, NSCD, and NCD.
• P-wave dispersion (PMD) may have a role in predicting SCD risk, warranting further research.