Background: Diastolic dysfunction has been implied as the central mechanism in heart failure with preserved ejection fraction. Recently, it has been found that p wave dispersion increases in diastolic dysfunction. This study aims to determine the p wave dispersion among Coronary Artery Disease patients with and without diastolic dysfunction and the relation to its severity.
Method: This is a retrospective case control study which included patients with angiographically documented CAD where the cases had Grades 1, 2 or 3 diastolic dysfunction while those with normal diastolic function served as the control. Their echocardiograms and 12 lead ECGs were reviewed and p wave dispersion values determined.
Results: A total of 118 patients were enrolled, 95 of whom have diastolic dysfunction. The p wave dispersion was 56 ± 14ms in patients with diastolic dysfunction and 48 ± 12ms in those without (0.02). When computed according to the severity, the p wave dispersion values were as follows: 56 ± 14ms for grade I, 49 ± 11ms for grade II, and 60 ± 14ms for grade III (0.01). For patients with concomitant systolic dysfunction, the p wave dispersion was 56 ± 14ms while it was 53 ± 13ms for those without systolic dysfunction (0.37).
Conclusion: P wave dispersion was significantly increased in patients with diastolic dysfunction compared with values from patients with normal diastolic function. P wave dispersion does not increase progressively with worsening diastolic function. Patients with concomitant systolic dysfunction had higher p wave dispersion values but this increase was not statistically significant.