Key result
Slow coronary flow was associated with significantly increased maximum P-wave duration (120 vs 115, p=0.003) and P-wave dispersion (44 vs 38, p=0.01) compared to healthy controls.
Why the study?
Is slow coronary flow associated with increased P-wave duration and dispersion compared to healthy subjects?
Case-Control (n=76)
Is slow coronary flow associated with increased P-wave duration and dispersion compared to healthy subjects?
Absolute Event Rate: 44% vs 38%
p-value: p=0.01
Patients with slow coronary flow exhibit prolonged P-wave duration and increased P-wave dispersion, which may reflect underlying microvascular ischemia or autonomic dysfunction.
Prolonged P-wave parameters in SCF suggest possible atrial vulnerability; leaves open arrhythmia risk prediction and need for prospective validation.
The slow coronary flow (SCF) phenomenon is often considered to be an incidental angiographic finding; however, several reports have shown it to be associated with cardiac events. In this study we aimed to assess P-wave duration and dispersion (PWD) in patients with SCF and to compare it with that of healthy subjects. Thus, 40 patients with angiographically proven SCF and otherwise normal coronary arteries (group 1) and 36 sex-age-matched healthy subjects (group 2) were included in this study. A 12-lead surface ECG, recorded at a paper speed of 50-mm/s and 2 mV/cm standardization, was obtained from each subject. P-wave duration was measured manually by use of a caliper. The difference between the maximum (Pmax) and minimum P (Pmin)-wave duration was calculated and defined as PWD. All subjects had undergone echocardiographic examination to exclude valvular disorders and wall motion abnormalities. There was no significant difference between the 2 groups in demographies of age, sex, heart rate, or blood pressure. Maximum P-wave duration and PWD were significantly higher in group 1 than in group 2 (120 +/-7 vs 115 +/-5, p = 0.003; 44 +/-12 vs 38 +/-9, p = 0.01, respectively). However, there was no significant difference in Pmin duration (75 +/-9 vs 78 +/-7, p = 0.4). In conclusion; SCF and otherwise normal epicardial coronary artery was found to be associated with prolonged P-wave duration and increased PWD. This may result from microvascular ischemia and/or altered autonomic control of cardiovascular system observed in this group of patients.
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Türkmen et al. (2007) conducted a case-control in Slow coronary flow (n=76). Slow coronary flow vs. Healthy subjects was evaluated on P-wave dispersion (p=0.01). Slow coronary flow was associated with significantly increased maximum P-wave duration (120 vs 115, p=0.003) and P-wave dispersion (44 vs 38, p=0.01) compared to healthy controls.
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