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Orthogonal P-wave morphology is affected by intra-atrial pressures

Petersson, Richard LU ; Smith, J. Gustav LU ; Larsson, David A. LU ; Reitan, Öyvind LU ; Carlson, Jonas LU orcid ; Platonov, Pyotr LU and Holmqvist, Fredrik LU (2017) In BMC Cardiovascular Disorders 17(1).
Abstract

BACKGROUND: It has previously been shown that the morphology of the P-wave neither depends on atrial size in healthy subjects with physiologically enlarged atria nor on the physiological anatomical variation in transverse orientation of the left atrium. The present study aimed to investigate if different pressures in the left and right atrium are associated with different P-wave morphologies.

METHODS: 38 patients with isolated, increased left atrial pressure, 51 patients with isolated, increased right atrial pressure and 76 patients with biatrially increased pressure were studied. All had undergone right heart catheterization and had 12-lead electrocardiographic recordings, which were transformed into vectorcardiograms for... (More)

BACKGROUND: It has previously been shown that the morphology of the P-wave neither depends on atrial size in healthy subjects with physiologically enlarged atria nor on the physiological anatomical variation in transverse orientation of the left atrium. The present study aimed to investigate if different pressures in the left and right atrium are associated with different P-wave morphologies.

METHODS: 38 patients with isolated, increased left atrial pressure, 51 patients with isolated, increased right atrial pressure and 76 patients with biatrially increased pressure were studied. All had undergone right heart catheterization and had 12-lead electrocardiographic recordings, which were transformed into vectorcardiograms for detailed P-wave morphology analysis.

RESULTS: Normal P-wave morphology (type 1) was more common in patients with isolated increased pressure in the right atrium while abnormal P-wave morphology (type 2) was more common in the groups with increased left atrial pressure (P = 0.032). Moreover, patients with increased left atrial pressure, either isolated or in conjunction with increased right atrial pressure, had significantly more often a P-wave morphology with a positive deflection in the sagittal plane (P = 0.004).

CONCLUSION: Isolated elevated right atrial pressure was associated with normal P-wave morphology while left-sided atrial pressure elevation, either isolated or in combination with right atrial pressure elevation, was associated with abnormal P-wave morphology.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atrial electrophysiology, Echocardiography, Electrocardiography, P-wave morphology, Pressure, Right heart catheterization
in
BMC Cardiovascular Disorders
volume
17
issue
1
pages
1 pages
publisher
BioMed Central (BMC)
external identifiers
  • pmid:29212469
  • scopus:85049291138
ISSN
1471-2261
DOI
10.1186/s12872-017-0724-x
language
English
LU publication?
yes
id
580c1bfd-69be-46f2-b544-f32a8f910ac8
date added to LUP
2018-07-19 11:38:23
date last changed
2024-03-01 22:11:25
@article{580c1bfd-69be-46f2-b544-f32a8f910ac8,
  abstract     = {{<p>BACKGROUND: It has previously been shown that the morphology of the P-wave neither depends on atrial size in healthy subjects with physiologically enlarged atria nor on the physiological anatomical variation in transverse orientation of the left atrium. The present study aimed to investigate if different pressures in the left and right atrium are associated with different P-wave morphologies.</p><p>METHODS: 38 patients with isolated, increased left atrial pressure, 51 patients with isolated, increased right atrial pressure and 76 patients with biatrially increased pressure were studied. All had undergone right heart catheterization and had 12-lead electrocardiographic recordings, which were transformed into vectorcardiograms for detailed P-wave morphology analysis.</p><p>RESULTS: Normal P-wave morphology (type 1) was more common in patients with isolated increased pressure in the right atrium while abnormal P-wave morphology (type 2) was more common in the groups with increased left atrial pressure (P = 0.032). Moreover, patients with increased left atrial pressure, either isolated or in conjunction with increased right atrial pressure, had significantly more often a P-wave morphology with a positive deflection in the sagittal plane (P = 0.004).</p><p>CONCLUSION: Isolated elevated right atrial pressure was associated with normal P-wave morphology while left-sided atrial pressure elevation, either isolated or in combination with right atrial pressure elevation, was associated with abnormal P-wave morphology.</p>}},
  author       = {{Petersson, Richard and Smith, J. Gustav and Larsson, David A. and Reitan, Öyvind and Carlson, Jonas and Platonov, Pyotr and Holmqvist, Fredrik}},
  issn         = {{1471-2261}},
  keywords     = {{Atrial electrophysiology; Echocardiography; Electrocardiography; P-wave morphology; Pressure; Right heart catheterization}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Cardiovascular Disorders}},
  title        = {{Orthogonal P-wave morphology is affected by intra-atrial pressures}},
  url          = {{http://dx.doi.org/10.1186/s12872-017-0724-x}},
  doi          = {{10.1186/s12872-017-0724-x}},
  volume       = {{17}},
  year         = {{2017}},
}