INTRODUCTION: The relationship between diastolic dysfunction and P-wave dispersion (PWD) in the electrocardiogram has been studied for some time. In this regard, echocardiography is emerging as a diagnostic tool to improve risk stratification for mild hypertension. OBJECTIVE: To determine the dependence of PWD on the electrocardiogram and on echocardiographic variables in a pediatric population. METHODS: 515 children from three elementary schools were studied from a total of 565 children. Those whose parents did not want them to take part in the study, as well as those with known congenital diseases, were excluded. Tests including 12-lead surface ECGs and 4 blood pressure (BP) measurements were performed. Maximum and minimum P-values were measured, and the PWD on the electrocardiogram was calculated. Echocardiography for structural measurements and the pulsed Doppler of mitral flow were also performed. RESULTS: A significant correlation in statistical variables was found between PWD and mean BP for pre-hypertensive and hypertensive children, i.e., r = 0.32, p <0.01 and r = 0.33, p <0.01, respectively. There was a significant correlation found between PWD and the left atrial area (r = 0.45 and p <0.01). CONCLUSIONS: We highlight the dependency between PWD, the electrocardiogram and mean blood pressure. We also draw attention to the dependence of PWD on the duration of the mitral inflow A-wave. This result provides an explanation for earlier changes in atrial electrophysiological and hemodynamic characteristics in pediatric patients.
INTRODUCTION: The relationship between diastolic dysfunction and P-wave dispersion (PWD) in the electrocardiogram has been studied for some time. In this regard, echocardiography is emerging as a diagnostic tool to improve risk stratification for mild hypertension. OBJECTIVE: To determine the dependence of PWD on the electrocardiogram and on echocardiographic variables in a pediatric population. METHODS: 515 children from three elementary schools were studied from a total of 565 children. Those whose parents did not want them to take part in the study, as well as those with known congenital diseases, were excluded. Tests including 12-lead surface ECGs and 4 blood pressure (BP) measurements were performed. Maximum and minimum P-values were measured, and the PWD on the electrocardiogram was calculated. Echocardiography for structural measurements and the pulsed Doppler of mitral flow were also performed. RESULTS: A significant correlation in statistical variables was found between PWD and mean BP for pre-hypertensive and hypertensivechildren, i.e., r = 0.32, p <0.01 and r = 0.33, p <0.01, respectively. There was a significant correlation found between PWD and the left atrial area (r = 0.45 and p <0.01). CONCLUSIONS: We highlight the dependency between PWD, the electrocardiogram and mean blood pressure. We also draw attention to the dependence of PWD on the duration of the mitral inflow A-wave. This result provides an explanation for earlier changes in atrial electrophysiological and hemodynamic characteristics in pediatric patients.
Authors: Kathleen Bird; Gabriel Chan; Huiqi Lu; Heloise Greeff; John Allen; Derek Abbott; Carlo Menon; Nigel H Lovell; Newton Howard; Wee-Shian Chan; Richard Ribon Fletcher; Aymen Alian; Rabab Ward; Mohamed Elgendi Journal: Front Med (Lausanne) Date: 2020-12-04