Relation Ship Between P Wave Dispersion and Diastolic Dyssfunction

Diastolic dysfunction of hypertrophic or ischemic left ventricle causes an increase in ventricular enddiastolic pressure and left atrial size. In this situation, continuity of sinus rhythm and atrial contractions are of great value for the maintenance of cardiac output. The aim of our study was to investigate the relationship between P wave dispersion, which is easily measured on the surface ECG and used in assessing the risk of atrial fibrillation, and left ventricular diastolic function. In our study, a total of 133 patients were included (73 patients with diastolic dysfunction assessed by transthorasic echocardiography and 60 patients without). P wave dispersions were calculated by measuring the P minimum and P maximum values on the surface ECG. The relation between P wave dispersion and presence of diastolic dysfunction, its etiology, severity and echocardiographic measurements were investigated. P dispersion was 53±9 ms in patients with diastolic dysfunction and 43±9 ms in the control group ( p< 0.01). When the patients were grouped according to the stage of diastolic dysfunction, P dispersion was 48±7 ms in stage 1, 54±8 ms in stage 2 and 58±9 ms in stage 3. It was noted that as the severity of diastolic dysfunction increased, P dispersion also increased without reaching statistical significance (p> 0.05). When the etiology of diastolic dysfunction was considered, P dispersion was 53±8 ms in patients with ischemic heart disease, and 52±9 ms in patients with left ventricular hypertrophy and a significant difference was not present (p> 0.05). Hence, in patients with diastolic dysfunction, P dispersion increases but this increase is not related to the severity of diastolic dysfunction or its etiology. When clinical and echocardiographic parameters are taken into account, there was a weak but significant correlation only between P dispersion and left ventricular ejection fraction.