Limits...
P-wave duration and dispersion in patients with peripheral edema and its amelioration.

Madias JE - Indian Pacing Electrophysiol J (2007)

Bottom Line: Although P-wave amplitudes and P-wave areas decreased with development of PERED (N = 16), and increased with its amelioration (N = 6), P-dur-mean before PERED was 66.8+/-14.5 ms, and at peak weight gain it was 65.2+/-11.9 ms, p = 0.66; also at peak weight gain and subsequent lowest weight, in the patients who lost weight, it was 66.5+/-9.9 ms and 72.3+/-12.0 ms, respectively, p = 0.38.Similarly the P-d prior to PERED was 62.3+/-25.2 ms, and at peak weight gain it was 74.3+/-29.3 ms, p = 0.09; also at peak weight and subsequent lowest weight, in the patients who lost weight, it was 58.8+/-34.2 ms, and 61.3+/-13.6 ms, respectively, p = 0.87.P-du-mean and P-d did not change in patients who developed PERED; their stability is attributed to the offsetting of the electrophysiologically-mediated real changes, by opposite apparent changes, imparted by PERED.

View Article: PubMed Central - PubMed

Affiliation: Mount Sinai School of Medicine, New York University, New York, NY, USA. madiasj@nychhc.org

ABSTRACT

Background: Attenuation of the P-wave amplitudes in patients with peripheral edema (PERED) has been recently reported, with P-waves regaining some of their amplitude in patients, who subsequently experienced amelioration of their PERED. Changes in the P-waves correlated with the corresponding alterations in the QRS complexes. Also since amplitudes and durations of QRS complexes changed in parallel in patients with PERED, it was hypothesized that similar changes in the P-wave amplitudes, mean P-wave duration (P-du-mean), and P-wave dispersion (P-d), would occur in such patients.

Methods: Measurements of P-wave amplitude, P-du-mean and P-d in patients who developed, or experienced alleviation, of PERED, were carried out and analyzed.

Results: Although P-wave amplitudes and P-wave areas decreased with development of PERED (N = 16), and increased with its amelioration (N = 6), P-dur-mean before PERED was 66.8+/-14.5 ms, and at peak weight gain it was 65.2+/-11.9 ms, p = 0.66; also at peak weight gain and subsequent lowest weight, in the patients who lost weight, it was 66.5+/-9.9 ms and 72.3+/-12.0 ms, respectively, p = 0.38. Similarly the P-d prior to PERED was 62.3+/-25.2 ms, and at peak weight gain it was 74.3+/-29.3 ms, p = 0.09; also at peak weight and subsequent lowest weight, in the patients who lost weight, it was 58.8+/-34.2 ms, and 61.3+/-13.6 ms, respectively, p = 0.87.

Conclusion: P-du-mean and P-d did not change in patients who developed PERED; their stability is attributed to the offsetting of the electrophysiologically-mediated real changes, by opposite apparent changes, imparted by PERED.

No MeSH data available.


Related in: MedlinePlus

Hypothetical cardiac and extracardiac influences on the P-wave duration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC1764906&req=5

Figure 3: Hypothetical cardiac and extracardiac influences on the P-wave duration.

Mentions: The above formulation does not imply that all the other known influences were not exerted in our patients with PERED. The edematous state produced reversible attenuation of the ΣP, P-amp-mean, and P-area-mean [1] (Table 1); however P-du-mean and all the other associated parameters did not change, as also noted in the "controls" who did not experience any changes in their body weights. These patients received large fluid volumes, suffered pneumonia and sepsis, were intubated, and developed acute renal failure [1,32], all conditions expecting to lead to prolongation of P-du-mean and P-d. Plausible explanations for the reduction of P-amp-mean, ΣP and P-area-mean, with unaltered P-durations are: 1) No changes in the P-durations occurred (Figure 3A), in-spite of the changes in P-wave amplitudes and areas. 2) Hemodynamic and or other electrophysiological influences leading to prolongation of the P-wave duration were exerted (Figure 3C), but they were counteracted by the shortening of the P-duration effect of PERED (Figure 3B), producing a cancellation effect (Figure 3D), and leading to an unchanged P-du-mean and P-d (Figure 3A and 3D). In short, it is proposed herein that the apparent influence of PERED has cancelled out the electrophysiologically-mediated real changes.


P-wave duration and dispersion in patients with peripheral edema and its amelioration.

Madias JE - Indian Pacing Electrophysiol J (2007)

Hypothetical cardiac and extracardiac influences on the P-wave duration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1764906&req=5

Figure 3: Hypothetical cardiac and extracardiac influences on the P-wave duration.
Mentions: The above formulation does not imply that all the other known influences were not exerted in our patients with PERED. The edematous state produced reversible attenuation of the ΣP, P-amp-mean, and P-area-mean [1] (Table 1); however P-du-mean and all the other associated parameters did not change, as also noted in the "controls" who did not experience any changes in their body weights. These patients received large fluid volumes, suffered pneumonia and sepsis, were intubated, and developed acute renal failure [1,32], all conditions expecting to lead to prolongation of P-du-mean and P-d. Plausible explanations for the reduction of P-amp-mean, ΣP and P-area-mean, with unaltered P-durations are: 1) No changes in the P-durations occurred (Figure 3A), in-spite of the changes in P-wave amplitudes and areas. 2) Hemodynamic and or other electrophysiological influences leading to prolongation of the P-wave duration were exerted (Figure 3C), but they were counteracted by the shortening of the P-duration effect of PERED (Figure 3B), producing a cancellation effect (Figure 3D), and leading to an unchanged P-du-mean and P-d (Figure 3A and 3D). In short, it is proposed herein that the apparent influence of PERED has cancelled out the electrophysiologically-mediated real changes.

Bottom Line: Although P-wave amplitudes and P-wave areas decreased with development of PERED (N = 16), and increased with its amelioration (N = 6), P-dur-mean before PERED was 66.8+/-14.5 ms, and at peak weight gain it was 65.2+/-11.9 ms, p = 0.66; also at peak weight gain and subsequent lowest weight, in the patients who lost weight, it was 66.5+/-9.9 ms and 72.3+/-12.0 ms, respectively, p = 0.38.Similarly the P-d prior to PERED was 62.3+/-25.2 ms, and at peak weight gain it was 74.3+/-29.3 ms, p = 0.09; also at peak weight and subsequent lowest weight, in the patients who lost weight, it was 58.8+/-34.2 ms, and 61.3+/-13.6 ms, respectively, p = 0.87.P-du-mean and P-d did not change in patients who developed PERED; their stability is attributed to the offsetting of the electrophysiologically-mediated real changes, by opposite apparent changes, imparted by PERED.

View Article: PubMed Central - PubMed

Affiliation: Mount Sinai School of Medicine, New York University, New York, NY, USA. madiasj@nychhc.org

ABSTRACT

Background: Attenuation of the P-wave amplitudes in patients with peripheral edema (PERED) has been recently reported, with P-waves regaining some of their amplitude in patients, who subsequently experienced amelioration of their PERED. Changes in the P-waves correlated with the corresponding alterations in the QRS complexes. Also since amplitudes and durations of QRS complexes changed in parallel in patients with PERED, it was hypothesized that similar changes in the P-wave amplitudes, mean P-wave duration (P-du-mean), and P-wave dispersion (P-d), would occur in such patients.

Methods: Measurements of P-wave amplitude, P-du-mean and P-d in patients who developed, or experienced alleviation, of PERED, were carried out and analyzed.

Results: Although P-wave amplitudes and P-wave areas decreased with development of PERED (N = 16), and increased with its amelioration (N = 6), P-dur-mean before PERED was 66.8+/-14.5 ms, and at peak weight gain it was 65.2+/-11.9 ms, p = 0.66; also at peak weight gain and subsequent lowest weight, in the patients who lost weight, it was 66.5+/-9.9 ms and 72.3+/-12.0 ms, respectively, p = 0.38. Similarly the P-d prior to PERED was 62.3+/-25.2 ms, and at peak weight gain it was 74.3+/-29.3 ms, p = 0.09; also at peak weight and subsequent lowest weight, in the patients who lost weight, it was 58.8+/-34.2 ms, and 61.3+/-13.6 ms, respectively, p = 0.87.

Conclusion: P-du-mean and P-d did not change in patients who developed PERED; their stability is attributed to the offsetting of the electrophysiologically-mediated real changes, by opposite apparent changes, imparted by PERED.

No MeSH data available.


Related in: MedlinePlus