The Relationship between P Wave and Corrected QT Dispersion with The Left Ventricular Ejection Fraction (LVEF) and The Severity of Coronary Artery Stenosis in Coronary Artery Disease: A Cross-sectional study

Background: Noninvasive electrocardiographic markers are useful for detecting atrial and ventricular dysrhythmias. In severe coronary artery disease (CAD), ventricular dysfunction and atrial ischemia may occur, leading to the prolongation of atrial depolarization. Objective: This study aimed to evaluate the relationship between P-wave and corrected QT parameters on electrocardiography (ECG) with the left ventricular ejection fraction (LVEF) and the severity of coronary artery disease (CAD). Method: This cross-sectional observational study collected secondary data from 117 patients with CAD who underwent coronary angiography and ECG recording between May 2022 and October 2023 at the Cardiac Center, Sultan Agung Islamic Hospital, Semarang. ECG parameters and echocardiographic quantification of LVEF were assessed by cardiologist prior to coronary angiography. The severity of CAD was assessed and classified based on the degree of stenosis. Result: Among the 117 patients, 86 (73.5%) were male, with a mean age of 59.47 ± 10.4 years. Maximum P wave interval (P max) and P wave dispersion (PWD) were significantly higher in the significant stenosis CAD group (105.12 ± 24.69 ms vs. 92.43 ± 27.64 ms, P = 0.02, 60.37 ± 24.72 ms vs. 42.70 ± 26.77 ms, P = 0.002, respectively). Corrected QT dispersion (QTcd) was borderline significantly higher in the significant stenosis CAD group (71.21 ± 31.85 ms vs. 59.75 ± 34.64, P = 0.09). Conclusion: Our results demonstrate a significant relationship of P max & PWD with the severity of CAD stenosis. No significant relationship was found between P wave & corrected QT findings and LVEF.