Association of P wave peak time with left ventricular end‐diastolic pressure in patients with hypertension

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Abstract

Left ventricular diastolic dysfunction (LVDD) is commonly seen in hypertensive patients, and it is associated with increased morbidity and mortality. Hence, the detection of LVDD with a simple, inexpensive, and easy-to-obtain method can contribute to improving patient prognosis. Therefore, we aimed to evaluate whether there was any association between the electrocardiographic P wave peak time (PWPT) and invasively measured left ventricular end-diastolic pressure (LVEDP) in hypertensive patients who had undergone coronary angiography following preliminary diagnosis of coronary artery disease. A total of 78 patients were included in this cross-sectional study. The PWPT was defined as the time from the beginning of the P wave to its peak, and it was calculated from the leads D_II and V_I . In all patients, LVEDP was measured in steady state. The PWPT in lead D_II was significantly longer in patients with high LVEDP; however, there was no significant difference between groups in terms of PWPT in the lead V_I . In multivariable analysis, PWPT in lead D_II was found to be independent predictor of increased LVEDP (OR: 1.257, 95% CI: 1.094-1.445; P = 0.001). In receiver operating characteristic curve analysis, the optimal cut-off value of PWPT in the lead D_II for prediction of elevated LVEDP was 64.8 ms, with a sensitivity of 68.7% and a specificity of 91.3% (area under curve: 0.882, 95% CI: 0.789-0.944, P II may be an independent predictor of increased LVEDP among hypertensive patients.

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