Abstract
It has previously been shown that maximum P-wave duration and P-wave dispersion in
12-lead surface electrocardiogram (ECG) are significantly increased in patients prone
to developing atrial fibrillation. Because patients with mitral stenosis (MS) are
also susceptible to developing atrial fibrillation, the present study was carried
out to determine whether maximum P-wave duration and P-wave dispersion are prolonged
in MS patients during normal sinus rhythm. In addition, the correlation between these
P-wave variables and the left atrial size, transmitral valve gradient and mitral valve
area were determined. Fifty consecutive patients (40 women and 10 men; mean age 35.76±6.59
years) with MS who were in normal sinus rhythm, and a control group of 50 age- and
sex-matched healthy persons were studied.
A 12-lead ECG was obtained for each subject. All ECGs were scanned through a Cannon
scanner at 300 dpi and saved as images in a personal computer. The minimum and maximum
P-wave durations, as well as P-wave dispersion, were subsequently calculated. In addition,
all patients were evaluated by echocardiography to measure the left atrial size, transmitral
valve gradient and mitral valve area by planimetry. The P-wave parameters were compared
between the two groups and the correlation between these parameters and the echocardiographic
variables were determined in patients with MS. The most important findings included
a significant prolongation of maximum P-wave duration in patients with MS compared
with controls (P<0.001), and a strong correlation between the maximum P-wave duration
and left atrial size (r=0.505, P<0.001), transmitral valve gradient (r=0.371, P=0.01)
and a significant negative correlation with mitral valve area (r=−0.379, P=0.007).
There was no correlation between the P-wave dispersion and echocardiographic parameters.
