Clinical and biological determinants of P-wave duration: cross-sectional data from the population-based CoLaus|PsyCoLaus study

Abstract

ObjectivesP-wave duration (PWD) is associated with the development of atrial arrhythmias, cardiovascular and all-cause mortality. With this study, we aimed to assess the distribution and determinants of PWD in the general population.DesignCross-sectional study using data collected between 2014 and 2016.SettingIn the population-based cohort CoLaus|PsyCoLaus, Lausanne, Switzerland, we used 12-lead ECGs to measure PWD. Potential demographic, clinical and biological determinants of PWD were collected by questionnaire, anthropometry, blood pressure measurement and biological assays.ParticipantsData from 3459 participants (55% women, 62±10 years, 93% Caucasian) were included. Participants were excluded if they presented with (1) no sinus rhythm or paced rhythm on the study ECG or Wolff-Parkinson-White ECG pattern; (2) missing or non-interpretable ECG; and (3) missing phenotypic data.Primary outcome measureDetermine (1) the PWD distribution and (2) the demographic, clinical and biological determinants of PWD in a large population-based cohort.ResultsMedian and IQR of PWD was 112 (102–120) ms . In the multivariable analyses, PWD was significantly associated with age (p<0.001) and height (p<0.001), with an adjusted regression coefficient (95% CI) of 0.29 ms/years (0.23 to 0.36) and 0.32 ms/cm (0.28 to 0.37), respectively. PWD, given thereafter in ms with adjusted mean±SE, was significantly (p<0.05) associated with (a) gender (woman 110.0±0.4; man 112.1±0.4), (b) body mass index (normal 110.1±0.4; overweight 110.9±0.4; obese 113.0±0.5), (c) abdominal obesity (no 110.5±0.3; yes 111.7±0.4) and (d) hypertension (no 110.4±0.3; yes 111.7±0.4).ConclusionPWD is positively associated with age, height, male gender, obesity markers and hypertension. Clinical interpretation of PWD should take these factors into consideration.

Using explainable AI to investigate electrocardiogram changes during healthy aging—From expert features to raw signals

“…The amplitude of the T-wave decreases with age and shifts to the right, indicating an overall longer cardiac cycle, meaning a slower heart rate. Furthermore, the T- and P-wave intervals shorten with age; moreover, the absolute magnitude of the S-peak, Q-peak, and P-wave appears to diminish with age as well, which is in accordance with [ 36 , 37 ]. It is noteworthy that the amplitude of the R-peak shows no conclusive trend with age.…”

The Effect of Obesity on Repolarization and Other ECG Parameters

“…Moreover, Cosgun et al’s study associated obesity with no other comorbidities to the increase in maximal values of P-wave width and the prolongation of P-wave dispersion [ 31 ]. Bocchi et al’s study also associated BMI and abdominal obesity with an increase in P-wave dispersion [ 32 ], and Seyfeli et al’s study associated obesity with an increase in P-wave dispersion [ 27 ]. Our research also found that P-wave duration and dispersion have higher values in overweight and obese people.…”

Resting membrane potential is less negative in trabeculae from right atrial appendages of women, but action potential duration does not shorten with age

“…decrease in maximum upstroke velocities with age [20]. Thus, structural changes may underlie the well-described conduction slowing atria in elderly humans [21]. From a clinical perspective, we would not expect a relevant contribution of age-dependent prolongation in APD 90 to AF.…”