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The relationship between P-wave peak time and albuminuria in hypertensive patients
Ayca Arslan1, Dogan Ilıs1, Inanc Artac1
1Department of Cardiology, Kafkas University School of Medicine, Kars, Türkiye.
Objective:
P-wave peak time (PWPT), a novel electrocardiographic marker reflecting atrial conduction delay and structural remodeling, has been associated with diastolic dysfunction and elevated left atrial pressure. Albuminuria, a marker of renal microvascular damage, has also been linked to subclinical diastolic dysfunction. This study aimed to investigate whether PWPT is independently associated with albuminuria in hypertensive patients and to assess its potential diagnostic utility.
Methods:
A total of 367 hypertensive patients were prospectively enrolled. Patients were categorized into albuminuria-positive (n = 110) and albuminuria-negative (n = 257) groups based on their spot urinary albumin-to-creatinine ratio (UACR). Those with UACR > 30 mg/g were classified as albuminuria-positive, and those with UACR < 30 mg/g were classified as albuminuria-negative. Comprehensive demographic, laboratory, electrocardiographic, and echocardiographic data were collected and compared between the two groups.
Results:
PWPT was significantly prolonged in patients with albuminuria (48 ± 11 ms vs. 39 ± 9 ms, p < 0.001). In multivariate analysis, PWPT (OR = 2.688, 95% CI: 1.969-3.672, p < 0.001) remained an independent predictor of albuminuria, along with HbA1c, left atrial volume index, and heart rate. PWPT exhibited the highest discriminatory power among these variables (AUC = 0.771), with a cutoff of >42 ms yielding 76.4% sensitivity and 68.1% specificity.
Conclusion:
PWPT is independently associated with albuminuria in hypertensive patients and may serve as a noninvasive marker of early renal microvascular involvement.
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