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Rivista sulle Malattie del Cuore e dei Vasi
Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,752
Minerva Cardioangiologica 2016 Ottobre;64(5):525-33
P wave analysis and left ventricular systolic function in chronic heart failure. Possible insights form the P wave - PP interval spectral coherence
Gianfranco PICCIRILLO 1, Federica MOSCUCCI 1, Claudia FIORUCCI 1, Gaetana D’ALESSANDRO 1, Matteo PASCUCCI 1, Damiano MAGRÌ 2 ✉
1 Department of Cardiovascular, Respiratory, Nephrological, Anesthesiology and Geriatric Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy; 2 Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant’Andrea, University of Rome, Rome, Italy
BACKGROUND: Chronic increase in left ventricular filling pressure represents one of the most important mechanism underlying the structural, as well as the electrical, atrial chamber remodeling leading to atrial fibrillation. The present pilot pathophysiological study sought to investigate possible relationship between short-period cross-spectral coherence of P-Q, R-R and P-P intervals and echocardiographic indices of left ventricular and atrial function.
METHODS: Electrocardiographic single lead short-term cross-spectral analysis on P-Q and P-P intervals was performed in 31 patients with chronic heart failure (CHF). Twenty age and therapy matched hypertensive patients acted as control group. The interval between the beginning of P wave and its peak (Ppeak) was also analyzed.
RESULTS: Patients with CHF showed a significant lower PQ → PP and Ppeak → PP coherence (P<0.001) than the counterpart. At multivariate analysis only Ppeak → PP was independently associated to LVEF (r2:0.312; b:60; β:0.559; P<0.0001) and atrial volume (r2:-0.160; b:-0.15; β:-0.400, P<0.05).
CONCLUSIONS: Ppeak → PP coherence might be a simple marker of left ventricular and atrial function. Whether this index could be a useful noninvasive marker of increased left ventricular filling pressure and, possibly, of atrial fibrillation risk or not, it needs to be tested in larger prospective studies.