CORRELATION BETWEEN P WAVE DISPERSION FROM 12-LEAD ECG AND LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS DIAGNOSED WITH HYPERTENSION

Abstract

Background: Patients diagnosed with hypertension generally have diastolic dysfunction of the left ventricle which causes an increase in LVEDP as well as in the dimension of the left atrium. Changes in the structure of the left atrium can be detected through P wave dispersion on a 12-lead Electrocardiography. The purpose of this study was to determine the correlation of P wave dispersion on the 12-lead Electrocardiography with diastolic dysfunction in patients diagnosed with hypertension in the outpatient clinic of Cardiac Center Adam Malik General Hospital in Medan.

Method: This is a cross-sectional study conducted from February 2019 till August 2019. Patients with hypertension who met the inclusion criteria was examined electrocardiographically to obtain P wave dispersion value. Then echocardiography examination was performed to assess the grades of diastolic dysfunction and other parameters. Analysis of correlation between P wave dispersion values and diastolic dysfunction was then conducted. Results: Significant differences in P-wave dispersion are found among diastolic dysfunction groups. Grade I diastolic dysfunction is found to have P wave dispersion value of 43 ms, grade II diastolic dysfunction has P wave dispersion value of 53 ms, and grade III diastolic dysfunction has P wave dispersion value of 56 ms, Significance of p value is <0.001. There is a strong correlation between P wave dispersion and diastolic dysfunction grade (r = 0.7 (P <0.001)). Cut off point of P-wave dispersion > 50.5 ms can discriminate patients who have increased LAP with a sensitivity of 83% and specificity of 93%.

Conclusion: P-wave dispersion is a simple screening tool which is widely available to detect grades of left ventricular diastolic dysfunction, especially in areas where echocardiography is not available.