Usefulness of P Wave Dispersion in Predicting Coronary Artery Disease Severity
Hande Kangül, Mehmet Eyüboğlu, Ömer Kozan
Keywords: P wave dispersion, myocardial perfusion scintigraphy, coronary artery disease
Introduction: Because only a small proportion of patients undergoing coronary angiography have obstructive coronary artery disease (CAD), further markers are necessary to predict CAD severity. The aim of our study was to investigate the importance of P wave dispersion for predicting obstructive CAD and its severity in patients undergoing coronary angiography for positive myocardial perfusion scintigraphy. Patients and Methods: Overall, 126 patients who underwent coronary angiography for positive myocardial perfusion scintigraphy were included in the study. The patients were divided into three groups based on coronary angiography findings: group 1, patients with non-obstructive CAD; group 2, patients with obstructive CAD in only one vessel; and group 3, patients with obstructive CAD in more than one vessel. The groups were compared for P wave duration and P wave dispersion. Gensini score was used to evaluate CAD severity. Results: There was no significant difference among the groups regarding P wave duration at rest. However, there was a significant difference among the groups regarding P wave duration at recovery (117.10 ± 13.69 msn, 127.64 ± 12.70 msn, 130.51 ± 11.84 msn, respectively, p< 0.001). When the groups were compared for P wave dispersion, we found a statistical significant difference among the groups (13.63 ± 6.38 msn, 22.48 ± 3.98 msn, 27.14 ± 6.22 msn, respectively, p< 0.001). There was a positive correlation between P wave dispersion and Gensini score (r= 0.390, p< 0.001). Conclusion: Our findings suggested that P wave dispersion increases the sensitivity and specificity of positive myocardial perfusion scintigraphy for predicting obstructive CAD and its severity.