Key result
P-wave area ≥ 4 ms x mv on ECG lead II demonstrated 85.8% sensitivity and 93.7% specificity for diagnosing left atrial enlargement in patients with mitral stenosis.
Why the study?
Does the P-wave area measured from ECG lead II accurately diagnose left atrial enlargement in patients with mitral stenosis?
Cross-Sectional (n=136)
Does the P-wave area measured from ECG lead II accurately diagnose left atrial enlargement in patients with mitral stenosis?
A P-wave area ≥ 4 ms x mv on lead II of a standard ECG provides a highly sensitive and specific new criterion for diagnosing left atrial enlargement in patients with mitral stenosis.
Answers are grounded in this paper and cite their sources.
May aid noninvasive left atrial enlargement assessment in mitral stenosis; leaves open prospective validation before clinical adoption.
OBJECTIVE: To investigate the value of the P-wave area in diagnosing left atrial enlargement in patients with mitral stenosis. METHODS: We measured the P-wave area from lead II of a standard 12-lead ECG in 136 consecutive patients with mitral stenosis. We also measured the left atrial diameter with two-dimensional echocardiography. RESULTS: Left atrial enlargement was identified in 120 (88.2%) patients. There was an excellent correlation between P-wave area and left atrial diameter in these patients (r = 0.739, p = 0.001). A P-wave area of > or = 4 ms x mv had an 85.8% sensitivity and 93.7% specificity for left atrial enlargement. There was also a smaller but significant correlation between left atrial diameter and the total P-wave duration (r = 0.635, p < 0.01) or P-wave amplitude (r = 0.683, p < 0.01) in these patients. However, the P-wave area had a better overall sensitivity than the P-wave duration (43.3%) or amplitude (10.8%) in diagnosing left atrial enlargement. CONCLUSIONS: Left atrium enlargement can be estimated by P-wave area measured from ECG lead II in patients with mitral stenosis. A P-wave area 24 ms x mv serves as a new criterion of left atrial enlargement.
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Zeng et al. (2003) conducted a cross-sectional in Mitral stenosis (n=136). P-wave area measurement from ECG lead II vs. Two-dimensional echocardiography was evaluated on Correlation between P-wave area and left atrial diameter (r = 0.739, p=0.001). P-wave area ≥ 4 ms x mv on ECG lead II demonstrated 85.8% sensitivity and 93.7% specificity for diagnosing left atrial enlargement in patients with mitral stenosis.
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