A1 Refereed original research article in a scientific journal
Prognostic value of P-wave morphology in general population
Authors: Laitinen Idamaria, Kenttä Tuomas V, Passi Jussi, Haukilahti Mira Anette E, Eranti Antti, Holkeri Arttu, Aro Aapo L, Kerola Tuomas, Noponen Kai, Seppänen Tapio, Rissanen Harri, Knekt Paul, Heliövaara Markku, Ukkola Olavi H, Junttila M Juhani, Huikuri Heikki V, Perkiömäki Juha S
Publisher: OXFORD UNIV PRESS
Publication year: 2022
Journal: EP-Europace
Journal name in source: EUROPACE
Journal acronym: EUROPACE
Article number: euac121
Number of pages: 11
ISSN: 1099-5129
DOI: https://doi.org/10.1093/europace/euac121
Publication's open availability at the time of reporting: No Open Access
Publication channel's open availability : Partially Open Access publication channel
Web address : https://doi.org/10.1093/europace/euac121
Aims: To evaluate the prognostic significance of novel P-wave morphology descriptors in general population.
Methods and results: Novel P-wave morphology variables were analyzed from orthogonal X-, Y-, Z-leads of the digitized electrocardiogram using a custom-made software in 6906 middle-aged subjects of the Mini-Finland Health Survey. A total of 3747 (54.3%) participants died during the follow-up period of 24.3 ± 10.4 years; 379 (5.5%) of the study population succumbed to sudden cardiac death (SCD), 928 (13.4%) to non-SCD (NSCD) and 2440 (35.3%) patients to non-cardiac death (NCD). In univariate comparisons, most of the studied P-wave morphology parameters had a significant association with all modes of death (P from <0.05 to <0.001). After relevant adjustments in the Cox multivariate hazards model, P-wave morphology dispersion (PMD) still tended to predict SCD [hazard ratio (HR): 1.006, 95% confidence interval (CI): 1.000-1.012, P = 0.05) but not NSCD (HR: 0.999, 95% CI: 0.995-1.003, P = 0.68) or NCD (HR: 0.999, 95% CI: 0.997-1.001, P = 0.44). The P-wave maximum amplitude in the lead Z (P-MaxAmp-Z) predicted SCD even after multivariate adjustments (HR: 1.010, 95% CI: 1.005-1.015, P = 0.0002) but also NSCD (HR: 1.005, 95% CI: 1.002-1.009, P = 0.0005) and NCD (HR: 1.002, 95% CI: 1.000-1.005, P = 0.03).
Conclusion: Abnormalities of P-wave morphology are associated with the risk of all modes of death in general population. After relevant adjustments, PMD was still closely associated with the risk of SCD but not with NSCD or NCD. P-MaxAmp-Z predicted SCD even after adjustments, however, it also retained its association with NSCD and NCD.
