İnanç Artaç1, Bahattin Balcı1, Serdar Sevimli2, Ahmet Karakurt1, İbrahim Rencüzoğulları1, Metin Çağdaş4, Yavuz Karabağ1, Doğan İliş3

1Department of Cardiology, Kafkas University Faculty of Medicine, Kars, Türkiye
2Department of Cardiology, Atatürk University Faculty of Medicine, Erzurum, Türkiye
3Clinic of Cardiology, Kars Harakani State Hospital, Kars, Türkiye
4Clinic of Cardiology, Gebze Fatih State Hospital, Kocaeli, Türkiye

Keywords: P wave; p wave peak time; diastolic dysfunction; hypertension; left atrium


Introduction: This study was designed to evaluate the relationship between left atrial volume index, which is an important indicator of left ventricular diastolic dysfunction, and electrocardiographic parameters such as P wave duration, P wave dispersion (PWDISP), P wave terminal force (PWTF), and P wave peak time (PWPT) in hypertensive patients.

Patients and Methods: A total of 58 patients with a diagnosis of hypertension between June 2017 and April 2018 were included in this retrospective study. Age-sex matched 58 healthy subjects constituted the control group. The patients without diastolic dysfunction and stage I diastolic dysfunction were included in the normal left atrial pressure (NLAP) group, while stage II and stage III diastolic dysfunction patients constituted the high left atrial pressure (HLAP) group.

Results: The PWDmax, PWDISP, and PWPT which are calculated from the lead DII (PWPTDII) were found to be longer in the group of hypertensive patients (p< 0.05, for all). Electrocardiographic parameters of PWDmax, PWDISP, PWTF, PWPTDII, and PWPTVI were found to be longer in patients with HLAP. Both PWPTVI (p= 0.008 r= 0.395) and PWPTDII (p< 0.001 r= 0.456) were significantly correlated with left atrial volume index.

Conclusion: In this study, the relationship between PWPT and diastolic dysfunction was revealed for the first time in the literature. In addition, the PWPT was found to be increased in patients with increased left atrial pressure (LAP). Our findings deserve attention because electrocardiography is an inexpensive and easily accessible diagnostic method that can be used to detect diastolic dysfunction in hypertensive patients.

Cite this article as: Artaç İ, Balcı B, Sevimli S, Karakurt A, Rencüzoğulları İ, Çağdaş M, et al. The relationship between electrocardiographic p wave parameters and left atrial volume and volume indices in patients with hypertension. Koşuyolu Heart J 2022;25(2):177-186.

Ethics Committee Approval

This study was approved by Kafkas University Faculty of Medicine (Decision no: 80576354-050-99/107, Date: 30.05.2018).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - İA, Dİ; Analysis/Interpretation - İA, Dİ, YK; Data Collection - İA, Dİ; Writing - İA, MÇ; Critical Revision - İA, BB; Final Approval - İA, MÇ, BB; Statistical Analysis - İA, YK; Overall Responsibility - İA, YK.

Conflict of Interest

The authors declared that there was no conflict of interest during the preparation and publication of this article.

Financial Disclosure

The authors declared that this study has received no financial support.