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The Relationship Between Aging and P Wave Dispersion

Year 2009, Volume: 12 Issue: 1, 5 - 9, 01.01.2008

Abstract

Objective: Atrial fibrillation (AF), commonly observed in advanced ages, displays striking age dependent increase and increased P wave dispersion (PWD) has been shown to be a predictor of AF. In this study we sought to determine whether P wave duration and PWD increase with aging. Method and Results: Eighty-three elderly subjects (group-I mean age 75±8 years) and 40 healthy young subjects (group-II, mean age 37±6 years) participated in this study. 12-lead ECG recorded at a paper speed of 50mm/s was obtained from each participant. Maximum (Pmax) and minimum P wave duration (Pmin) was measured manually with a caliper and the difference between two values was defined as PWD. Pmax and PWD were significantly higher in group-I compared to group-II. (98±8 vs. 93±8 p=0.01, 41±12 vs. 34±13 p=0.002, respectively). Among the elderly population when those with cardiovascular disorders such as hypertension, coronary artery disease and heart failure were excluded, Pmax and PWD were still significantly higher than the young population. (Pmax: 98±7 vs. 93±7, p=0.02 and PWD: 42±11 vs. 34±13, p=0.002). Moreover, on correlation analysis a positive correlation was detected between Pmax and PWD and aging. (r=0.29, p=0.004; r=0.30, p=0.003 respectively). Conclusion: PWD shows age dependent increase and may be a useful marker for estimation the risk of developing AF seen in advanced ages

References

  • Fleg JL, Kennedy HL. Cardiac arrhythmias in a healthy elderly population: Detection by 24-hour ambulatory electrocardiography. Chest 1982; 81:302-307.
  • Kannel WB, Abbot RD, Savage DD, McNamara PM. Coronary heart disease and atrial fibrillation: The Framingham Study Am Heart J 1983;106:389-396.
  • Yamashita T, Murakawa Y, Hayami N, et al. Relation between aging and circadian variation of paroxysmal atri- al fibrillation. Am J Cardiol 1998; 82:1364-1367.
  • Altunkeser BB, Ozdemir K, Gok H, Temizhan A, Tokac M, Karabag T. Can P wave parameters obtained frm
  • lead surface electrocardiogram be a predictor for
  • atrial fibrillation in patients who have structural heart
  • disease? Angiology 2003;54:475-9.
  • Dilaveris PE, Gialafos EJ, Andrikopoulos GK, et al. Clinical and electrocardiographic predictors of recurrent atrial fibrillation. Pacing Clin Electrophysiol 2000;23:352- 358.
  • Dilaveris PE, Gialafos EJ, Sideris S, et al. Simple elec- trocardiographic markers for the prediction of paroxys- mal idiopathic atrial fibrillation. Am Heart J 1998135:733- 738.
  • Gunduz H, Binak E, Arinc H, et al. The relationship between P wave dispersion and diastolic dysfunction. Texas Heart Inst Journal 2005;32:163-165.
  • Myrianthefs MM, Ellestad MH, Startt-Selvester RH, Crump R. Significance of signal-averaged P-wave changes during exercise and correlation with angio- graphic findings. Am J Cardiol 1991;68:1619-1624.
  • Myrianthefs MM, Shandling AH, Startt-Selvester RH, et al. Analysis of the signal-averaged P-wave duration in patients with percutaneous coronary angioplasty- induced myocardial ischemia. Am J Cardiol 1992;70:728- 732.
  • Furberg CD, Manolio T, Psaty BM, et al. Major elec- trocardiographic abnormalities in persons aged 65 years and old. Am J Cardiol 69:1329-1335, 1992.
  • Buxton AE, Waxman HL, Marchlinski FL, Josephson ME. Atrial conduction: Effects of extrastimuli with and without atrial dysrhythmias. Am J Cardiol 1984;54:755- 61.
  • Leier CV, Meacham JA, Schall SF. Prolonged atrial conduction: A major predisposing factor to atrial flutter. Circulation 1978; 57:213-216.
  • Wei JY: Age and the cardiovascular system. New Eng J Med 1992;327:1735-1739.
  • Folkow B, Svanborg A: Physiology of cardiovascular aging. Physiol Rev 1993; 73:724-764.
  • Kavanagh KM, Wyse DG, Mitchell LB, Duff HJ. Cardiac refractoriness. Age-dependence in normal sub- jects. J Electrocardiol 1989;22:221-225.
  • Lakatta EG, Mitchell JH, Pomerance A, Rowe GG. Human aging: changes in structure and function. J Am Coll Cardiol 1987;10 suppl A:42A-47A.
  • Mitchelucci A, Padeletti L, Fradella GA, et al. Aging and electrophysiologic properties in man. Int J Cardiol 1984,5:75-81.
  • Elveback L, Lie JT. Continued high incidence of coro- nary artery disease at autopsy in Olmsted County, Minnesota 1950 to 1979. Circulation 1984;70:345-349.
  • Wenger NK. Cardiovascular disease in the elderly. Curr Probl Cardiol 1992;17:609-690.
  • Ferrari AU. Modifications of the cardiovascular sys- tem with aging. Am J Geriatric Cardiol 2002;11:30-33.
  • Fukusaki C, Kawakubo K, Yamamato Y. Assesment of primary effect of aging on heart rate variability in humans.Clin Auton Res 2000;10:123-130.
  • Seals DR, Esler MD. Human ageing and sympathoad- renal system. J Physiol 2000, 528:407-417.
  • Coumel P. Neural aspect of paroxismal atrial fibrilla- tion. In: falk RH, Podrid PJ, editors, Atrial Fibrillation: mechanisms and management, New York:Raven Press, 1992, pp 109-125.
  • Cheema AN, Ahmed MW, Kadish AH, Goldberger JJ. Effects of autonomic stimulation and blockade on signal- averaged P wave duration. J Am Coll Cardiol 1990; 26:497-502.
  • Tukek T, Akkaya V, Demirel S, et al. Effect of valsalva maneuver on surface electrocardiographic P wave dis- persion in paroxysmal atrial fibrillation. Am J Cardiol 2000; 85: 896-899.
  • Guidera SA, Steinberg JS. The signal-averaged P wave duration: a rapid and noninvasive marker of risk for atrial fibrillation. J Am Coll Cardiol 1993;21:1645-1651.
  • Aytemir K, Ozer N, Atalar E, et al. P wave dispersion on 12-lead electrocardiography in patients with paroxys- mal atrial fibrillation. Pacing Clin Electrophsiol 2000; 23:1109-1112.

Yafl ile P Dalga Dispersiyonu Aras›ndaki Iliflki

Year 2009, Volume: 12 Issue: 1, 5 - 9, 01.01.2008

Abstract

Amaç: ‹leri yafllarda yag›n olarak görülen atriyal fibrilasyon; yafl ba¤›ml› olarak çarp›c› bir art›fl göstermektedir ve artm›fl p dalga dispersiyonunun atriyal fibrilasyonun bir ön gördürücüsü oldu¤u gösterilmifltir. Bu çal›flmada, yaflla birlikte p dalga dispersiyonunun art›p artmad›¤›n› araflt›rd›k. Metod ve Bulgular: 83 yafll› hasta (grup-1; yafl ortalamas› 75±8 y›l) ve 40 sa¤l›kl› genç birey (grup-2; yafl ortalamas› 37±6 y›l) bu çal›flmaya dahil edildi. Her bir kat›l›mc›dan 50 mm/s ka¤›t h›z›nda 12-derivasyonlu EKG kayd› al›nd›. Maksimum ve minimum p dalga süreleri cetvel ile manuel olarak ölçüldü ve her iki de¤er aras›ndaki fark P dalga dispersiyonu (PDD) olarak tan›mland›. grup-1 maksimum p dalga süresi ve PDD anlaml› flekilde grup-2'den yüksek idi (98±8 ve 93±8 ms p=0.01; 41±12 ve 34±13 ms p=0.002, s›ras› yla). Yafll› grup aras›nda hipertansiyon, koroner arter hastal›¤› ve kalp yetersizli¤i gibi kardiyovasküler hastal›klar› olanlar d›flland›¤›nda bile maksimum p dalga süresi ve PDD yine de genç popülasyondan yüksek idi (Pmax: 98±7 ve 93±7 ms, p=0.02; PDD: 42±11 ve 34±13ms, p=0.002). Üstelik, korelasyon analizinde maksimum p dalga süresi, PDD ve yafl aras›nda pozitif bir korelasyon saptand› (r=0.29, p=0.004; r=0.30, p=0.003 s›ras›yla). Sonuç: PDD yafl ba¤›ml› art›fl göstermektedir ve ileri yafllarda görülen atriyal fibrilasyon geliflim riskini tahmin etmek için faydal› bir gösterge olabilir.

References

  • Fleg JL, Kennedy HL. Cardiac arrhythmias in a healthy elderly population: Detection by 24-hour ambulatory electrocardiography. Chest 1982; 81:302-307.
  • Kannel WB, Abbot RD, Savage DD, McNamara PM. Coronary heart disease and atrial fibrillation: The Framingham Study Am Heart J 1983;106:389-396.
  • Yamashita T, Murakawa Y, Hayami N, et al. Relation between aging and circadian variation of paroxysmal atri- al fibrillation. Am J Cardiol 1998; 82:1364-1367.
  • Altunkeser BB, Ozdemir K, Gok H, Temizhan A, Tokac M, Karabag T. Can P wave parameters obtained frm
  • lead surface electrocardiogram be a predictor for
  • atrial fibrillation in patients who have structural heart
  • disease? Angiology 2003;54:475-9.
  • Dilaveris PE, Gialafos EJ, Andrikopoulos GK, et al. Clinical and electrocardiographic predictors of recurrent atrial fibrillation. Pacing Clin Electrophysiol 2000;23:352- 358.
  • Dilaveris PE, Gialafos EJ, Sideris S, et al. Simple elec- trocardiographic markers for the prediction of paroxys- mal idiopathic atrial fibrillation. Am Heart J 1998135:733- 738.
  • Gunduz H, Binak E, Arinc H, et al. The relationship between P wave dispersion and diastolic dysfunction. Texas Heart Inst Journal 2005;32:163-165.
  • Myrianthefs MM, Ellestad MH, Startt-Selvester RH, Crump R. Significance of signal-averaged P-wave changes during exercise and correlation with angio- graphic findings. Am J Cardiol 1991;68:1619-1624.
  • Myrianthefs MM, Shandling AH, Startt-Selvester RH, et al. Analysis of the signal-averaged P-wave duration in patients with percutaneous coronary angioplasty- induced myocardial ischemia. Am J Cardiol 1992;70:728- 732.
  • Furberg CD, Manolio T, Psaty BM, et al. Major elec- trocardiographic abnormalities in persons aged 65 years and old. Am J Cardiol 69:1329-1335, 1992.
  • Buxton AE, Waxman HL, Marchlinski FL, Josephson ME. Atrial conduction: Effects of extrastimuli with and without atrial dysrhythmias. Am J Cardiol 1984;54:755- 61.
  • Leier CV, Meacham JA, Schall SF. Prolonged atrial conduction: A major predisposing factor to atrial flutter. Circulation 1978; 57:213-216.
  • Wei JY: Age and the cardiovascular system. New Eng J Med 1992;327:1735-1739.
  • Folkow B, Svanborg A: Physiology of cardiovascular aging. Physiol Rev 1993; 73:724-764.
  • Kavanagh KM, Wyse DG, Mitchell LB, Duff HJ. Cardiac refractoriness. Age-dependence in normal sub- jects. J Electrocardiol 1989;22:221-225.
  • Lakatta EG, Mitchell JH, Pomerance A, Rowe GG. Human aging: changes in structure and function. J Am Coll Cardiol 1987;10 suppl A:42A-47A.
  • Mitchelucci A, Padeletti L, Fradella GA, et al. Aging and electrophysiologic properties in man. Int J Cardiol 1984,5:75-81.
  • Elveback L, Lie JT. Continued high incidence of coro- nary artery disease at autopsy in Olmsted County, Minnesota 1950 to 1979. Circulation 1984;70:345-349.
  • Wenger NK. Cardiovascular disease in the elderly. Curr Probl Cardiol 1992;17:609-690.
  • Ferrari AU. Modifications of the cardiovascular sys- tem with aging. Am J Geriatric Cardiol 2002;11:30-33.
  • Fukusaki C, Kawakubo K, Yamamato Y. Assesment of primary effect of aging on heart rate variability in humans.Clin Auton Res 2000;10:123-130.
  • Seals DR, Esler MD. Human ageing and sympathoad- renal system. J Physiol 2000, 528:407-417.
  • Coumel P. Neural aspect of paroxismal atrial fibrilla- tion. In: falk RH, Podrid PJ, editors, Atrial Fibrillation: mechanisms and management, New York:Raven Press, 1992, pp 109-125.
  • Cheema AN, Ahmed MW, Kadish AH, Goldberger JJ. Effects of autonomic stimulation and blockade on signal- averaged P wave duration. J Am Coll Cardiol 1990; 26:497-502.
  • Tukek T, Akkaya V, Demirel S, et al. Effect of valsalva maneuver on surface electrocardiographic P wave dis- persion in paroxysmal atrial fibrillation. Am J Cardiol 2000; 85: 896-899.
  • Guidera SA, Steinberg JS. The signal-averaged P wave duration: a rapid and noninvasive marker of risk for atrial fibrillation. J Am Coll Cardiol 1993;21:1645-1651.
  • Aytemir K, Ozer N, Atalar E, et al. P wave dispersion on 12-lead electrocardiography in patients with paroxys- mal atrial fibrillation. Pacing Clin Electrophsiol 2000; 23:1109-1112.
There are 30 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

İrfan Barutçu This is me

Özlem Esen This is me

Dayimi Kaya This is me

Ersel Onrat This is me

Mehmet Melek This is me

Ataç Çelik This is me

Celal Kilit This is me

Ali Metin Esen This is me

Publication Date January 1, 2008
Published in Issue Year 2009 Volume: 12 Issue: 1

Cite

APA Barutçu, İ. ., Esen, Ö. ., Kaya, D. ., Onrat, E. ., et al. (2008). Yafl ile P Dalga Dispersiyonu Aras›ndaki Iliflki. Koşuyolu Kalp Dergisi, 12(1), 5-9. https://doi.org/10.17557/tjfc.88155
AMA Barutçu İ, Esen Ö, Kaya D, Onrat E, Melek M, Çelik A, Kilit C, Esen AM. Yafl ile P Dalga Dispersiyonu Aras›ndaki Iliflki. Koşuyolu Kalp Dergisi. January 2008;12(1):5-9. doi:10.17557/tjfc.88155
Chicago Barutçu, İrfan, Özlem Esen, Dayimi Kaya, Ersel Onrat, Mehmet Melek, Ataç Çelik, Celal Kilit, and Ali Metin Esen. “Yafl Ile P Dalga Dispersiyonu Aras›ndaki Iliflki”. Koşuyolu Kalp Dergisi 12, no. 1 (January 2008): 5-9. https://doi.org/10.17557/tjfc.88155.
EndNote Barutçu İ, Esen Ö, Kaya D, Onrat E, Melek M, Çelik A, Kilit C, Esen AM (January 1, 2008) Yafl ile P Dalga Dispersiyonu Aras›ndaki Iliflki. Koşuyolu Kalp Dergisi 12 1 5–9.
IEEE İ. . Barutçu, Ö. . Esen, D. . Kaya, E. . Onrat, M. . Melek, A. . Çelik, C. . Kilit, and A. M. . Esen, “Yafl ile P Dalga Dispersiyonu Aras›ndaki Iliflki”, Koşuyolu Kalp Dergisi, vol. 12, no. 1, pp. 5–9, 2008, doi: 10.17557/tjfc.88155.
ISNAD Barutçu, İrfan et al. “Yafl Ile P Dalga Dispersiyonu Aras›ndaki Iliflki”. Koşuyolu Kalp Dergisi 12/1 (January 2008), 5-9. https://doi.org/10.17557/tjfc.88155.
JAMA Barutçu İ, Esen Ö, Kaya D, Onrat E, Melek M, Çelik A, Kilit C, Esen AM. Yafl ile P Dalga Dispersiyonu Aras›ndaki Iliflki. Koşuyolu Kalp Dergisi. 2008;12:5–9.
MLA Barutçu, İrfan et al. “Yafl Ile P Dalga Dispersiyonu Aras›ndaki Iliflki”. Koşuyolu Kalp Dergisi, vol. 12, no. 1, 2008, pp. 5-9, doi:10.17557/tjfc.88155.
Vancouver Barutçu İ, Esen Ö, Kaya D, Onrat E, Melek M, Çelik A, Kilit C, Esen AM. Yafl ile P Dalga Dispersiyonu Aras›ndaki Iliflki. Koşuyolu Kalp Dergisi. 2008;12(1):5-9.