Analysis of relationship between P wave dispersion and diagnosis of pulmonary arterial hypertension and risk stratification

Abstract Objectives: The aim of this study was to measure the P-wave dispersion(PWD) in the ECG of patients with pulmonary arterial hypertension(PAH). Methods: A total of 103 PAH patients were collected, including 55 patients related with CHD and 44 patients with IPAH. In addition, 30 CHD patients without PAH (nPAH-CHD group) and 30 healthy controls (HCG group) were collected as control. Patients in the PAH group were categorized into the low-risk group (30 cases), moderate-risk group (53 cases) and high-risk group (20 cases), followed by comparison of PWD difference between groups. The ROC curve was used to evaluate the diagnostic efficacy of PWD on PAH-CHD and IPAH. Results: The levels of PWD and Pmax in PAH-CHD and IPAH group were significantly higher than those in nPAH-CHD and HCG group (P<0.05). PWD level was positively correlated with RVD, RAS, mPAP, PVR (r=0.407, 0.470, 0.477, 0.423, P<0.001), and was negatively correlated with TAPSE level (r =-0.551, P<0.001). After risk quantification in 103 PAH patients, we found that PWD was significantly different among the low-risk, moderate-risk and high-risk groups (43.89 ± 9.91 vs. 51.29 ± 6.61, 62.15 ± 10.44, P<0.001). CHD-PAH and IPAH were identified by PWD with a cut off value of 41.5ms (P< 0.001), and a cut off value of 41.45ms (P< 0.001), respectively. Conclusion: PWD might be an effective ECG indicator for PAH, which might be used as a relatively economical and easily accessible indicator for PAH patients to assist in early diagnosis, disease severity assessment and prognosis evaluation.