Hipertensión arterial en población pediátrica, sus efectos en la dispersión de la onda P y el área auricular izquierda

Chávez, Elibet; González, Emilio; Castro, Jesús; Llanes, María del C.; Garí, Merlin; García, Yosvany; Carmona, Raimundo; Ramos, Ramiro

doi:10.4067/s0718-85602010000300006

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…The left atrial area can be increased due to the systemic pressure overloads. A previous pediatric study 31 shows higher values in the left atrial area in hypertensive children compared to normotensive children as well as a significant linear relationship between P-wave dispersion and the left atrial area in hypertensive children.…”

Section: Discussionmentioning

confidence: 69%

Relationship between P-wave dispersion, left ventricular mass index and blood pressure

chavez¹

2013

Arch Argent Pediat

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Introduction. The study of arterial hypertension risk factors in children guarantees the establishment of health policies to avoid complications associated with this illness in the future. The highest values of P-wave dispersion during sinus rhythm are pointed as predictors of atrial fibrillation in adulthood since there is an association between arterial hypertension, P-wave dispersion and left ventricular hypertrophy. The aim of this study was to determine the relationship between blood pressure, left ventricular mass index and P-wave dispersion in the pediatric population. Population and methods. In the frame of the PROCDEC II project, children from 8 to 11 years old, without known heart conditions were studied. Arterial blood pressure was measured in all the children; a 12-lead surface ECG and an echocardiogram were done as well. Results. Left ventricular mass index mean values for normotensive (25.21 ± 5.96 g/m 2) and hypertensive (30.38 ± 7.39 g/m 2) children showed significant differences (p= 0.000). The mean value of the left atrial area was significantly different (p= 0.000) when comparing prehypertensive (10.98 ± 2.23 cm2) and hypertensive (12.21 ± 1.27 cm 2) children to normotensive ones (10.66 ± 2.38 cm 2). The correlation of P-wave dispersion and the left ventricular mass index showed an r= 0.87 and p= 0.000. Conclusions. P-wave dispersion is increased in pre-and hypertensive children compared to normotensive ones. A dependence of the P-wave dispersion of the left ventricular mass index was found in hypertensive children.

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Section: Discussionmentioning

confidence: 69%

Relationship between P-wave dispersion, left ventricular mass index and blood pressure

chavez¹

2013

Arch Argent Pediat

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“…It was noted that this increase in PWD indicates increased atrial vulnerability to the development of atrial arrhythmia. Chávez et al 22 , also described a positive correlation between PWD and the left atrial area in hypertensive children.…”

Section: Discussionmentioning

confidence: 88%

Dependence of P-wave dispersion on mean arterial pressure as an independent hemodynamic variable in school children

González¹,

Rodríguez²,

Camacho³

2013

Colomb Med

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Introduction:The relationship between diastolic dysfunction and P-wave dispersion (PWD) in the electrocardiogram has been studied for some time. In this regard, echocardiography is emerging as a diagnostic tool to improve risk stratification for mild hypertension. Objective:To determine the dependence of PWD on the electrocardiogram and on echocardiographic variables in a pediatric population. Methods: Five hundred and fifteen children from three elementary schools were studiedfrom a total of 565 children. Those whose parents did not want them to take part in the study, as well as those with known congenital diseases, were excluded. Tests including 12-lead surface ECGs and 4 blood pressure (BP) measurements were performed. Maximum and minimum P-values were measured, and the PWD on the electrocardiogram was calculated. Echocardiography for structural measurements and the pulsed Doppler of mitral flow were also performed. Results: A significant correlation in statistical variables was found between PWD and mean BP for pre-hypertensive and hypertensive children, i.e., r= 0.32, p <0.01 and r= 0.33, p <0.01, respectively. There was a significant correlation found between PWD and the left atrial area (r= 0.45 and p <0.01). Conclusions: We highlight the dependency between PWD, the electrocardiogram and mean blood pressure. We also draw attention to the dependence of PWD on the left atrial area. This result provides an explanation for earlier changes in atrial electrophysiological and hemodynamic characteristics in pediatric patients.

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“…[1][2][3][4][5]46,47] An earlier Cuban study demonstrated greater atrial size and higher Pd in hypertensive children than in normotensive ones. [25] Another study, also in Cuba, found increased left ventricular mass index in hypertensive children, with higher Pd than in normotensive children. [24] Neither of the two earlier studies [24,25] evaluated the association between BP and Pd as this study did.…”

Section: Original Researchmentioning

confidence: 93%

“…[25] Another study, also in Cuba, found increased left ventricular mass index in hypertensive children, with higher Pd than in normotensive children. [24] Neither of the two earlier studies [24,25] evaluated the association between BP and Pd as this study did.…”

Section: Original Researchmentioning

confidence: 93%

“…P-wave was measured manually using a ruler (BIOTRONIK, Germany), according to the method described by Chávez and Carmona, employed in other published studies. [23][24][25] For this study, EKGs with 10 or more leads with measureable P-waves were used, following guidelines for P-wave measurement and Pd calculation. [1,26] None of the EKG measurements was excluded.…”

Section: Bp Measurement and Map Calculationmentioning

confidence: 99%

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P-Wave Dispersion: A Possible Warning Sign of Hypertension in Children

Chávez¹,

González

Llanes³

et al. 2014

MEDICC Review

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This study is part of the Development Center Community Outreach project for diagnosis and management of hypertension in children (PROCDEC II) in Spain and Cuba, which began in 2000; the Cuban segment includes 5025 children aged 8-11 years from 43 urban primary schools in the municipality of Santa Clara in Villa Clara Province and involves a multidisciplinary research group of pediatricians, cardiologists, pediatric cardiologists, endocrinologists, clinical laboratory specialists, psychologists, statisticians and computer scientists. [15] A detailed clinical history was taken of all children and pertinent testing performed (two-dimensional abdominal and renal ultrasound, renal artery Doppler ultrasound, thyroid hormones, echocardiogram to rule out coarctation of the aorta, vanilmandelic acid, fundoscopic exam, creatinine, proteinuria, albuminuria and microalbuminuria) to diagnose essential and secondary hypertension. Participants were also assessed for other comorbidities (diabetes; hematologic, renal and adrenal diseases; hypertrophic cardiomyopathy) and for pubertal development (Tanner stage). [16] Type of study and sample A cross-sectional study was conducted from September 2009 through June 2011, using cluster sampling and randomly selecting the schools involved, with

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Hipertensión arterial en población pediátrica, sus efectos en la dispersión de la onda P y el área auricular izquierda

Cited by 6 publications

References 11 publications

Relationship between P-wave dispersion, left ventricular mass index and blood pressure

Relationship between P-wave dispersion, left ventricular mass index and blood pressure

Dependence of P-wave dispersion on mean arterial pressure as an independent hemodynamic variable in school children

P-Wave Dispersion: A Possible Warning Sign of Hypertension in Children

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