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A short P-wave duration is associated with incident heart failure in the elderly: a 15 years follow-up cohort study

Journal of Geriatric Cardiology 2022年第9期19卷 643-650页

作者： Bozena Ostrowska Lars Lind elena sciaraffia Carina Blomström-Lundqvist Department of Medical Sciences Uppsala UniversityUppsalaSweden School of Medical Science Faculty of Medi-cine and HealthÖrebro UniversityÖrebroSweden

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.

关键词： prevention incident wave

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