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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

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Atrial Cardiomyopathy Detected by Electrocardiogram: Association with Stroke in a Brazilian Electronic Cohort

Filipe Antunes de Lêu1, Gabriela Miana de Mattos Paixão1, Ana Cecilia Oliveira1

  • 1Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil.

Arquivos Brasileiros De Cardiologia
|May 6, 2026
PubMed

Insights

Electrocardiogram (ECG) markers for atrial cardiomyopathy (AC) are linked to increased stroke risk and mortality. These findings highlight the prognostic value of ECG in identifying patients at higher risk for adverse cardiovascular events.

Area of Science:

  • Cardiology
  • Public Health
  • Biomedical Engineering

Background:

  • Atrial cardiomyopathy (AC) is a condition detectable by electrocardiogram (ECG).
  • AC may significantly contribute to stroke etiology, independent of atrial fibrillation (AF).

Purpose of the Study:

  • To investigate the association between ECG markers of AC and stroke-related mortality and hospitalization.
  • Specific ECG markers evaluated include prolonged P-wave duration (>120 ms) and P-terminal force in V1 (PTFV1) (>4,000 µV·ms).

Main Methods:

  • Retrospective cohort study of 245,588 patients in sinus rhythm, aged ≥40, from Belo Horizonte (2006-2018).
  • ECG data were linked to public mortality (SIM) and hospitalization (SIH) databases.
  • Cox regression analysis was used to determine hazard ratios (HRs) with incremental adjustments.

Main Results:

  • 26.3% of patients had prolonged P-wave duration and 10.1% had elevated PTFV1.
  • Prolonged P-wave duration was associated with increased mortality/hospitalization due to stroke (HR 1.24; p<0.001).
  • Elevated PTFV1 was also associated with stroke outcomes (HR 1.20; p<0.001).

Conclusions:

  • ECG markers of AC demonstrate significant prognostic value.
  • These markers are associated with death or hospitalization due to stroke.
  • AC markers also predict cardiovascular mortality and incident AF in this cohort.
Abstract

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