P Pulmonale and the Development of Atrial Fibrillation

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概要

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• Background: P wave ≥0.25mV in inferior leads (P pulmonale) occurs in chronic lung diseases that underlie atrial fibrillation (AF). The purpose of this study was to elucidate the prognostic value of P pulmonale for development of AF. Methods and Results: Digital analysis of 12-lead electrocardiogram (ECG) was conducted to enroll patients with P pulmonale from among a database containing 308,391 ECGs. In a total of 591 patients (382 men; 56.4±14.8 years) with P pulmonale (follow-up, 46.7±65.6 months), AF occurred in 61 patients (AF group), but did not occur in 530 patients (non-AF group). Male gender was significantly more prevalent in the AF group than in the non-AF group (80.3% vs. 62.8%, P=0.0047). P-wave duration and PQ interval were significantly longer in the AF group than in the non-AF group (115.4±17.2ms vs. 107.0±17.2ms, P=0.0003 and 166.3±23.9ms vs. 153.2±25.4ms, P=0.0001, respectively). In the total patient group, multivariate Cox proportional-hazards analysis confirmed that male gender (hazard ratio [HR], 2.24; 95% confidence interval [CI]: 1.02–5.49; P=0.045), PQ interval >150ms (HR, 6.89; 95% CI: 2.39–29.15; P<0.0001), and P-wave axis <74° (HR, 2.55; 95% CI: 1.20–5.41; P=0.016) were associated with AF development. In medication-free patients (n=400), only PQ interval >150ms (HR, 9.26; 95% CI: 1.75–170.65; P=0.0055) was independently and significantly associated with AF development. Conclusions: PQ interval is the strongest stratifier for AF development in P pulmonale.

• 一般社団法人 日本循環器学会の論文

著者

• Horie Minoru

  Department Of Cardiac Physiology National Cardiovascular Center Research Institute

• Naiki Nobu

  Department Of Cardiology Nagahama City Hospital

• XUE Joel

  General Electric Healthcare

• Matsumoto Tetsuya

  Department Of Cardiovascular And Respiratory Medicine

• Miyamoto Akashi

  Department Of Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Kawaguchi Tamiro

  Department Of Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Hayashi Hideki

  Department Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka

• Matsumoto Tetsuya

  Department of Health and Life Science, Osaka Kyoiku University

• Horie Minoru

  Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science

• Murakami Yoshitaka

  Health Science, Shiga University of Medical Science

• Miyamoto Akashi

  Departments of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science

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