Relationship Between the Presystolic Wave and the Electrocardiographic Diastolic Index in Hypertensive Patients

Objectives: To examine the association between the presystolic wave (PSW), an echocardiographic parameter indicative of diastolic dysfunction (DD), and the electrocardiographic diastolic index (EDI), which is calculated using 12-lead electrocardiography (ECG), in hypertensive cases. Methods: The study included 250 consecutive patients diagnosed with hypertension, evaluated in two groups: According to PSW presence. Statistical analyses were conducted to compare demographic data, laboratory parameters, and 12-lead ECG parameters between the groups with and without PSW. Results: PSW was found to be linked to advanced age (p<0.001), systolic blood pressure (p=0.045), diastolic blood pressure (p=0.020), fasting blood glucose (p=0.015), blood urea nitrogen (p=0.044), left ventricular wall thickness (p<0.001), mitral valve late diastolic wave (A wave, p=0.002), mitral valve early diastolic wave (E wave)/early diastolic myocardial wave (E’ wave) ratio (p<0.001), E/A ratio (p=0.031), AVL R amplitude (p=0.003), V1 S amplitude (p=0.020), V5 R amplitude (p=0.004), D1 P wave duration (p=0.017), PQ interval (p=0.011), QRS duration (p=0.015), and EDI (p<0.001). Age, A wave, and EDI (p<0.001) were found to independently predict PSW presence. Conclusion: We determined that, in addition to the echocardiographic assessment of PSW, EDI, an index that can be easily calculated using a 12-lead ECG, may also be a useful parameter for evaluating DD in hypertensive patients.