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P pulmonale and the development of atrial fibrillation

机译：肺炎与心房颤动的发展

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Background: P wave ≥0.25 mV in inferior leads (P pulmonale) occurs in chronic lung diseases that underlie atrial fibrillation (AF). The purpose of this study was to elucidate the prognostic value of P pulmonale for development of AF. Methods and Results: Digital analysis of 12-lead electrocardiogram (ECG) was conducted to enroll patients with P pulmonale from among a database containing 308,391 ECGs. In a total of 591 patients (382 men; 56.4±14.8 years) with P pulmonale (follow-up, 46.7±65.6 months), AF occurred in 61 patients (AF group), but did not occur in 530 patients (non-AF group). Male gender was significantly more prevalent in the AF group than in the non-AF group (80.3% vs. 62.8%, P=0.0047). P-wave duration and PQ interval were significantly longer in the AF group than in the non-AF group (115.4±17.2 ms vs. 107.0±17.2 ms, P=0.0003 and 166.3±23.9 ms vs. 153.2±25.4 ms, P=0.0001, respectively). In the total patient group, multivariate Cox proportional-hazards analysis confirmed that male gender (hazard ratio [HR], 2.24; 95% confidence interval [CI]: 1.02-5.49; P=0.045), PQ interval >150 ms (HR, 6.89; 95% CI: 2.39-29.15; P<0.0001), and P-wave axis <74° (HR, 2.55; 95% CI: 1.20-5.41; P=0.016) were associated with AF development. In medication-free patients (n=400), only PQ interval >150 ms (HR, 9.26; 95% CI: 1.75-170.65; P=0.0055) was independently and significantly associated with AF development. Conclusions: PQ interval is the strongest stratifier for AF development in P pulmonale.
机译：背景：在导致心房纤颤（AF）的慢性肺部疾病中，下导联P肺波≥0.25mV。这项研究的目的是阐明肺炎对AF的预后价值。方法和结果：进行了12导联心电图（ECG）的数字分析，以从包含308,391个ECG的数据库中招募P肺炎患者。在总共591例（382名男性; 56.4±14.8岁）的P型肺炎患者中（随访46.7±65.6个月），AF发生在61例患者中（AF组），但没有发生在530例患者中（非AF）组）。房颤组的男性性别明显高于非房颤组（80.3％比62.8％，P = 0.0047）。 AF组的P波持续时间和PQ间隔明显长于非AF组（115.4±17.2 ms vs.107.0±17.2 ms，P = 0.0003和166.3±23.9 ms vs.153.2±25.4 ms，P =分别为0.0001）。在总患者组中，多因素Cox比例风险分析证实为男性（风险比[HR]为2.24; 95％置信区间[CI]：1.02-5.49; P = 0.045），PQ区间> 150 ms（HR， 6.89; 95％CI：2.39-29.15; P <0.0001），P波轴<74°（HR，2.55; 95％CI：1.20-5.41; P = 0.016）与房颤发展有关。在无药物治疗的患者（n = 400）中，仅PQ间隔> 150 ms（HR，9.26; 95％CI：1.75-170.65; P = 0.0055）与房颤的发展独立且显着相关。结论：PQ间隔是肺炎性房颤发生的最强分层。

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