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Correlation Between P wave axis from Electrocardiogram and Left Atrial Volume Index in Healthy Obese Young Adults

Author : V. Victory, E. Chandra, A. Saboe, M. R. Akbar, Augustine P, T. M. Aprami
Upload Date : 19-04-2018

Background : Enlargement of the left atrium is a marker of mortality in the general population. Left atrial volume index (LAVi)  has long been proposed as a measure of prognosis in patients with cardiovascular disease. P wave axis presumably could substitute imaging examination using echocardiography in remote places where the medical facilities is insufficient. P wave axis in ECG can represent left atrial enlargement. We assume that p wave axis correlates well with LAVi, and it can predict left atrial volume in more simple and easier examination. Obesity contributes to left atrial enlargement (LAE). The mechanisms responsible for LAE in obesity are multifactorial and still in controversy.

Methods : This study was conducted in a single center with cross – sectional design, consecutive to all young adult (18-39 year old )  with obesity ( Body Mass Index > 30 kg/m2 ,  based on WHO criteria )  that worked in Hasan Sadikin General Hospital, Bandung, during August – November 2017. P wave axis measured by 12 lead ECG with value outside 0 to 75o, LAVi  was measured by 2D echocardiography using biplane method and performed by 2 experienced cardiologist.  Correlations between p wave  axis and LAVi measured using spearman correlation tests.

Results :  A total of  32 patient ( 71,9% male, 30,41 + 5,36 years old) were included in this study. The mean of BMI were 33.59 kg/m2 . Correlation between p axis {16.3 (8.6-25.9)} and LAVi (16.61 + 4.45) ml/m2 was statistically significant (p= 0.001; r= 0.723; CI95%= 0.475-0.895)

Conclusion :  P wave axis in ECG is strongly correlated with LAVi to measure left atrial enlargement. Further study is needed to investigate whether P wave axis could substitute imaging examination using echocardiography in remote places where the medical facilities is insufficient.

KEYWORDS : Left atrial volume index, obese, P wave axis, young adults

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