August 9, 2016Blood Pressure
Relationship between abnormal P-wave terminal force in lead V₁ and left ventricular diastolic dysfunction in hypertensive patients: the LIFE study
Key result
Abnormal P-wave terminal force in lead V1 at baseline was associated with significantly increased odds of abnormal mitral valve E/A ratio at 3 years (OR 1.55; 95% CI 1.04-2.32; p=0.032).
Why the study?
Does abnormal P-wave terminal force in lead V1 predict left ventricular diastolic dysfunction in hypertensive patients?
Population
431 hypertensive patients undergoing protocol-driven blood pressure reduction who had baseline and year-3…
Comparison
Presence of abnormal P-wave terminal force in… vs Absence of abnormal PTF-V1 at baseline
Design
Cohort
Follow-up
3 years
Authors
Discussion
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Implication
May flag early diastolic dysfunction risk in hypertension; hypothesis-generating and requires prospective validation before clinical use.
Study Design
Type
Cohort (n=431)
Structured PICO
Does abnormal P-wave terminal force in lead V1 predict left ventricular diastolic dysfunction in hypertensive patients?
P
Population
431 hypertensive patients undergoing protocol-driven blood pressure reduction who had baseline and year-3 ECG and echocardiographic data and a preserved LV ejection fraction (EF >45%) at year-3
I
Intervention
Presence of abnormal P-wave terminal force in lead V1 (PTF-V1) at baseline (defined as a negative terminal P-wave in lead V1 ≥ 4000 μV·ms)
C
Comparator
Absence of abnormal PTF-V1 at baseline
O
Outcome
Left ventricular diastolic function (including diastolic first third filling time, first half filling time, mitral valve A velocity, and mitral valve E/A ratio) at year-3surrogate
Main Result
Effect estimate: OR 1.55 (95% CI 1.04-2.32)
p-value: p=0.032
Abnormal P-wave terminal force in lead V1 is an ECG marker that predicts worse left ventricular diastolic function in hypertensive patients with preserved ejection fraction.
Cite This Study
Tanoue et al. (2016) conducted a cohort in Hypertension (n=431). Abnormal P-wave terminal force in lead V1 (PTF-V1) vs. Normal PTF-V1 was evaluated on Abnormal mitral valve E/A ratio (OR 1.55, 95% CI 1.04-2.32, p=0.032). Abnormal P-wave terminal force in lead V1 at baseline was associated with significantly increased odds of abnormal mitral valve E/A ratio at 3 years (OR 1.55; 95% CI 1.04-2.32; p=0.032).