A short P-wave duration is associated with incident heart failure in the elderly: a 15 years follow-up cohort study
Bozena Ostrowska1
Lars Lind1
Elena Sciaraffia1
Carina Blomstr?m-Lundqvist2
1.Department of Medical Sciences,Uppsala University,Uppsala,Sweden2.Department of Medical Sciences,Uppsala University,Uppsala,Sweden;School of Medical Science,Faculty of Medi-cine and Health,?rebro University,?rebro,Sweden
摘要：BACKGROUND Early identification of patients at risk of congestive heart failure (HF) may alter their poor prognosis. The aim was therefore to test whether simple electrocardiographic variables, the P-wave and PR-interval, could predict incident HF. METHODS The PIVUS (Prospective Investigation of the Vasculature in Uppsala Seniors) study (1016 individuals all aged 70 years, 50％ women) was used to identify predictors of HF. Subjects with prevalent HF, QRS duration ≥ 130 ms, atrial tachyar-rhythmias, implanted pacemaker/defibrillator, second- and third-degree atrioventricular block or delta waves at baseline were excluded. Cox proportional hazard analysis was used to relate the PR interval, P-wave duration (Pdur) and amplitude (Pamp), measured in lead V1, to incident HF. Adjustment was performed for gender, RR-interval, beta-blocking agents, systolic blood pressure, body mass index and smoking. RESULTS Out of 836 subjects at risk, 107 subjects were diagnosed with HF during a follow-up of 15 years. In the multivariate analysis, there was a strong U-shaped correlation between Pdur in lead V1 and incident HF (P = 0.0001) which was significant for a Pdur < 60 ms [HR = 2.75; 95％ CI: 1.87-4.06, at Pdur 40 ms] but not for prolonged Pdur. There was no significant relationship between incident HF and the PR-interval or the Pamp. A Pdur < 60 ms improved discrimination by 3.7％ when added to the tradi-tional risk factors including sex, RR-interval, beta-blocking agents, systolic blood pressure, BMI and smoking (P = 0.048). CONCLUSIONS A short Pdur, an easily measured parameter on the ECG, may potentially be a useful marker of future HF, enabling its early detection and prevention, thus improving outcomes.
机标关键词：heartstudywithassociatedcohortdurationelderlyfailure
论文发表日期：2022-09-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 643-650 )