creators_name: Ozmen, Namik creators_name: Cebeci, Bekir Sitki creators_name: Kardesoglu, Ejder creators_name: Celik, Turgay creators_name: Dincturk, Mehmet creators_name: Demiralp, Ergun editors_name: Singh, Balbir editors_name: Lokhandwala, Yash editors_name: Francis, Johnson editors_name: Gupta, Anup type: journalp datestamp: 2006-01-06 lastmod: 2011-03-11 08:56:17 metadata_visibility: show title: P Wave Dispersion is Increased in Pulmonary Stenosis ispublished: pub subjects: ipej full_text_status: public keywords: P wave dispersion; pulmonary stenosis abstract: Aim: The right atrium pressure load is increased in pulmonary stenosis (PS) that is a congenital anomaly and this changes the electrophysiological characteristics of the atria. However, there is not enough data on the issue of P wave dispersion (PWD) in PS. Methods: Forty- two patients diagnosed as having valvular PS with echocardiography and 33 completely healthy individuals as the control group were included in the study. P wave duration, p wave maximum (p max) and p minimum (p min) were calculated from resting electrocariography (ECG) obtained at the rate of 50 mm/sec. P wave dispersion was derived by subtracting p min from p max. The mean pressure gradient (MPG) at the pulmonary valve, structure of the valve and diameters of the right and left atria were measured with echocardiography. The data from two groups were compared with the Mann-Whitney U test and correlation analysis was performed with the Pearson correlation technique. Results: There wasn’t any statistically significance in the comparison of age, left atrial diameter and p min between two groups. While the MPG at the pulmonary valve was 43.11 ± 18.8 mmHg in PS patients, it was 8.4 ± 4.5 mmHg in the control group. While p max was 107.1 ± 11.5 in PS group, it was 98.2 ± 5.1 in control group (p=0.01), PWD was 40.4 ± 1.2 in PS group, and 27.2 ± 9.3 in the control group (p=0.01)Moreover, while the diameter of the right atrium in PS group was greater than that of the control group, (38.7 ± 3.9 vs 30.2 ± 2.5, p=0.02). We detected a correlation between PWD and pressure gradient in regression analysis. Conclusion: P wave dispersion and p max are increased in PS. While PWD was correlated with the pressure gradient that is the degree of narrowing, it was not correlated with the diameters of the right and left atria. date: 2006-01 date_type: published publication: Indian Pacing and Electrophysiology Journal volume: 6 number: 1 publisher: Indian Pacing and Electrophysiology Group pagerange: 25-30 refereed: TRUE referencetext: 1. Turhan H, Yetkin E, Senen K, Yilmaz MB, Ileri M, Atak R, Cehreli S, Kutuk E. Effects of percutaneous mitral balloon valvuloplasty on p-wave dispersion in patients with mitral stenosis. Am J Cardiol 2002;89(5):607-9. 2. Turhan H, Yetkin E, Atak R, Altinok T, Senen K, Ileri M, Sasmaz H, Cehreli S, Kutuk E. Increased p-wave duration and p-wave dispersion in patients with aortic stenosis. Ann Noninvasive Electrocardiol 2003;8(1):18-21. 3. Ciaroni S, Cuenoud L, Bloch A. Clinical study to investigate the predictive parameters for the onset of atrial fibrillation in patients with essential hypertension. Am Heart J. 2000 ;139(5):814-9. 4. Guray U, Guray Y, Yilmaz MB, Mecit B, Sasmaz H, Korknaz S, Kutuk E. Evaluation of P wave duration and P wave dispersion in adult patients with secundum atrial septal defect during normal sinus rhythm. Int J Cardiol. 2003 Sep;91(1):75-9. 5. Ho TF, Chia EL, Yip WC, Chan KY. Analysis of P wave and P dispersion in children with secundum atrial septal defect. Ann Noninvasive Electrocardiol. 2001;6(4):305-9. 6. Tukek T, Yildiz P, Akaya V, Karan MA, Atiıgan D, Yilmaz V, Korkut F. Factors associated with the development of atrial fibrillation in COPD patients: the role of p-wave dispersion. 7. Szabo Z, Kakuk G, Fulop T, Matyus J, Balla J, Karpati I, Juhasz A, Kun C, Karanyi Z, Lorinez I. Effects of haemodialysis on maximum P wave duration and P wave dispersion. Nephrol Dial Transplant 2002;17:1634-38. 8. Dilaveris PE, Gialafos EJ, Sideris SK, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998;135:733-8. 9. Tsikouris JP, Klugger J, Song J, White CM. Changes in p-wave dispersion and pwave duration after open heart surgery aer associaeted with peak incidence of atrial fibrillation. Heart Lung 2001;30:466-71. 10. Dilaveris PE, Gialafos EJ, Andrikopoulos GK, Richter DJ, Papanikopoulos V, Poralis K, Gialafos JE. Clinical and electrocardiographic predictors of recurrent atrial fibrillatio. Pacing Clin Electrophysiol 2000;23:352-8. 11. Aytemir K, Ozer N, Atalar E, Sade S, Aksoyek S, Ovunc K, Oto A, Ozmen F, Kes S. P wave dispersion on 12-lead electrocardiography in patients with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 2000;23.1109-12. 12. Buxton AE, Waxman HL, Marchlinski FE, Josephson ME. Atrial conduction: effects of extrastimuli with and without atrial dysrhythmias. Am J Cardiol 1984;54:755-61. 13. Song J, Kalus JS, Caron MF, Kluger J, White CM. Effects of diuresis on P wave duration and dispersion. Pharmacotherapy 2002;22(5):564-8. 14. Josephson ME, Kastor JA, Morganroth J. Electrocardiographic left atrial enlargment: electrophysiological, echocardiographic and hemodynamic correlates. Am J Cardiol 1977;39:967-71. 15. Ishimoto N, Ito M, Kinoshita M. Signal-averaged P wave abnormalities and atrial size in patients with and without idiopathic paroxysmal atrial fibrillation. Am Heart J 2000;139:684-689. citation: Ozmen, Namik and Cebeci, Bekir Sitki and Kardesoglu, Ejder and Celik, Turgay and Dincturk, Mehmet and Demiralp, Ergun (2006) P Wave Dispersion is Increased in Pulmonary Stenosis. [Journal (Paginated)] document_url: http://cogprints.org/4674/1/ozmen.htm document_url: http://cogprints.org/4674/2/ozmen.pdf