Relationship Between ECG and Left Atrial Hemodynamics in Patients with Mitral Stenosis

Background: Electrocardiography (ECG) in patients with mitral stenosis (MS) reveals characteristic findings, including altered P-wave morphology, reflecting left atrial (LA) hemodynamic changes. This research focused on the relationship between ECG parameters and LA hemodynamics in patients with severe MS. Methods: A cross-sectional retrospective study was conducted on 42 patients undergoing Percutaneous Transluminal Mitral Commissurotomy at Shafa Hospital, Kerman, Iran. ECG parameters, echocardiographic measurements, and angiographic findings were analyzed to assess associations between P-wave morphology and LA hemodynamic variables. Results: Significant correlations were found between LA volume and P-wave duration, amplitude, area, and terminal force in lead V1 ( P < 0.05). However, no significant correlations were observed between LA pressure or strain and ECG parameters. Discussion: The present study highlights a significant correlation between P-wave morphology in the ECG and LA volume. Notably, the relationship between P duration and LA volume was more pronounced compared to other electrocardiographic parameters. Additionally, LA strain and strain rate analysis revealed an inverse relationship with LA volume, underscoring the potential of these metrics in assessing atrial function. Conclusion: ECG parameters, particularly P-wave morphology, exhibit significant associations with LA volume in severe MS patients. These findings suggest the potential utility of ECG as a cost-effective tool for assessing LA volume and identifying patients who may be at risk for atrial fibrillation in MS.