Usefullness of P-wave and QT Dispersions for Predicting Early Death in Patients with Acute Pulmonary Embolism

OBJECTIVE: We aimed to demonstrate and compare to each other the relations of QT and P wave dispersions with early death in the course of acute pulmonary embolism (PE). MATERIALS AND METHODS: The archive data of 124 patients who had been hospitalized in our hospital with the diagnosis of acute PE between May 2012 and June 2013 was retrospectively reviewed. 93 patients who were in sinus rhythm and whose data were suitable for QT interval and P wave analyses were included to the study. Analyses of corrected QT interval dispersion (QTcd) and P wave dispersion (Pd) were performed for each patients. RESULTS: Among the study population, 12 patients (13%) died and 81 patients (87%) lived after the diagnosis of PE. PD values of deaths were significantly higher than those who survived (59.2±21.2 msec versus 44.8±13.5 msec respectively, p=0.04). Moreover, QTcd values of deaths were also significantly higher than the survivors (105.5 msec (99-119) versus 80msec (74-88) respectively, p<0.001). The sensitivity of Pd>64.5 msec for prediction of early mortality was found to be 58.3% with a specificity of 97.5% (p=0.017) where the sensitivity of Qtcd> 97 msec for prediction of early mortality was found to be 83.3% with a specificity of 82.7% (p<0.001). CONCLUSION: Both electrocardiography parameters Pd and QTcd may be used as a good and useful markers. We found that, in comparison to Pd, QTcd is superior to detect those who were under potential high risk and who need more aggressive treatment in the course of acute PE.