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538175 
Journal Article 
The relationship between the left attial volume and the maximum P-wave and P-wave dispeision in patients with congestive heaft failure 
Yjrn, DH; Vim, GC; Vim, SH; Yu, HK; Choi, WG; An, IS; Kwan, J; Park, KS; Lee, WH 
2007 
1 
Yonsei Medical Journal
ISSN: 0513-5796
EISSN: 1976-2437 
48 
5 
810-817 
English 
Purpose: A maximum P-wave duration (Pmax) of >= 110 msec and a P-wave dispersion (PWD) >= 40 msec are accepted indicators of a disturbance in interatrial conduction and an inhomogeneous propagation of the sinus impulse, respectively. The left atrial (LA) volume has been reported to be strongly associated with a systolic and diastolic dysfunction and is considered to be an index of atrial remodeling. We aimed to investigate the relationship between LA volume and Pmax or PWD in patients with congestive heart failure (CHF). Patients and Methods: Sixty-one patients with CHF were enrolled in this study. The study population was classified into four groups: two groups were divided according to the Pmax >= 110 msec or < 110 ins), and the other two groups were formed based on the PWD ( 40 msec or < 40 msec). The left atrial volume index (LAVi) was measured by three-dimensional (3-D) transthoracic echocardiography. The Pmax and PWD were measured from a 12-lead electrocardiogram. Results: There were significant differences in the ejection fraction (EF), diastolic function, and LAVi between patients with a P-max >= 110ms or a PWD >= 40 ms and those with a Pmax <110 ms or a PWD < 40 ms. The LAVi was independently associated with a disturbance in interatrial conduction and an inhomogeneous propagation of the sinus impulse. The LAVi can be used to identify patients with a disturbance in interatrial conduction and an inhomogeneous propagation of the sinus impulse with reasonably good accuracy. Conclusion: We concluded that a disturbance in interatrial conduction and an inhomogenous propagation of the sinus impulse in patients with CHF is associated with an increase in the LA volume and a deleterious systolic and diastolic dysfunction. 
P-wave duration; P-wave dispersion; heart failure; left atrial volume; left atrial volume; ventricular diastolic dysfunction; interatrial; block; echocardiographic assessment; fibrillation; size; risk; validation; dispersion; duration