Clinical Importance of P Wave Dispersion in Mitral Valve Prolapse

Mitral valve prolapse (MVP) is a widespread valvulopathy present in 2-6% of the population, affecting more than 170 million people globally. The objective of this study was to assess P wave dispersion (PWD) in patients with MVP to identify the presence of cardiovascular autonomic dysfunction and the potential risk of developing atrial arrhythmias in these patients.

The study included 40 healthy control participants (Group 1), 41 patients with non-classic MVP (Group 2), and 36 patients with classic MVP (Group 3). Demographic and clinical characteristics were documented upon admission. An electrocardiographic assessment was conducted to quantify PWD values for both patients and the control group.

The minimum P wave duration was lower in classic MVP patients than in controls and non-classic MVP patients (63±3.6 vs. 70±2.0, p<0.001; 63±3.6 vs. 63±3.6, p<0.001, respectively). P wave dispersion was higher in classic MVP patients than in non-classic MVP patients (47.3±3.2 vs. 39.0±2.3, p=0.001). A significant positive correlation was detected between PWD and maximum P wave duration (P_max), minimum P wave duration (P_min), maximal leaflet displacement, maximal leaflet thickness, and left atrial diameter (LAD) (r=0.723, p<0.001; r=-0.771, p<0.001; r=0.557, p<0.001; r=0.770, p<0.001; r=0.517, p<0.001, respectively). Maximum leaflet thickness and maximum leaflet displacement were independent predictors of increased PWD in linear regression analysis (β=1.456, p<0.001, β=-0.851, p<0.001).

Patients with classic MVP exhibited prolonged PWD values compared with non-classic MVP patients and normal controls.