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vol.9 número1Chronic pain and general self-perceived health in a Paraguayan reference hospitalAssociation of left atrial dilatation with hemodynamic alterations of the left ventricle in patients with arterial hypertension of the Hospital de Clinicas. Asuncion, Paraguay índice de autoresíndice de assuntospesquisa de artigos
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Revista de salud publica del Paraguay

versão On-line ISSN 2307-3349

Resumo

SCAVENIUS, Karina Elizabeth et al. Correlation among P wave dispersion and cardiac arrhythmias and alterations of the conduction system in patients with arterial hypertension from the Hospital de Clinicas, Asunción, Paraguay. Rev. salud publica Parag. [online]. 2019, vol.9, n.1, pp.47-56. ISSN 2307-3349.  https://doi.org/10.18004/rspp.2019.junio.47-56.

Introduction:

High blood pressure can produce atrial changes that generate atrial arrhythmias. P wave dispersion (PWD) is considered a noninvasive electrocardiographic marker for atrial remodeling and a predictor for the development of atrial fibrillation. Our objective is to study the correlation between the dispersion of the P wave with cardiac arrhythmias and conduction system disorders in patients with arterial hypertension (AHT).

Methodology:

Observational and prospective study in which we studied the electrocardiographic variations, echocardiographic measurements and Holter ECG of 24 hours in hypertensive patients who attend a tertiary hospital from March 2018 to September 2018 on an outpatient basis.

Results:

104 patients were studied, 65 known hypertensive patients and, 39 non-hypertensive as control group. The average value of the P wave dispersion in hypertensive patients was 37±8 ms, and in the control group it was 27±13 ms, P <0.001. In addition, a significant difference between these two groups was found in the maximum duration of the P wave (p <0.05), and the diameter of the left atrium (p <0.05). The PWD has a specificity of 72% and a negative predictive value of 78% related to the presence of disorders of the conduction system and cardiac arrhythmias in patients with hypertension. In addition, the PWD has a specificity of 73% and a negative predictive value of 83% related to the presence of the widening of the QRS complex.

Conclusion:

There is a greater significant alteration in the P Wave dispersion, the maximum P Wave, and the dilatation of the left atrium in AHT. A significant correlation was also observed between the dispersion of the P wave and the risk of developing atrial arrhythmias. The P wave dispersion has a high specificity and a high negative predictive value in the detection of the presence of QT interval prolongation, widening of the QRS complex, dilatation of the left atrium and disorders of the conduction system and cardiac arrhythmias in patients with arterial hypertension.

Palavras-chave : P wave dispersion; Arterial Hypertensión; Cardiac arrhythmias.

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