https://doi.org/10.1007/s00392-025-02625-4
1Klinikum der Ruhr-Universität Bochum Medizinische Klinik II, Kardiologie Bochum, Deutschland; 2Kath. Klinikum Neurologie Bochum, Deutschland; 3Kath. Klinikum Bochum Kardiologie und Rhytmologie Bochum, Deutschland; 4Universitätsklinikum Münster Klinik für Kardiologie II - Rhythmologie Münster, Deutschland
Background: Various P-wave parameters are used to diagnose atrial cardiomyopathy (AtCM). However, it is not clear which P-wave parameters are associated with alterations in left atrial hemodynamics. In this study, the hemodynamics of patients with pathological P-wave terminal force (PTFV1) ≤ -4000 µV*ms and advanced interatrial block (IAB) were analyzed.
Methods: In this AtCM study, patients with embolic stroke of undetermined source (ESUS), atrial fibrillation (AF) and cardiac healthy individuals were screened from December 2022 to August 2024. Inclusion criteria were sinus rhythm at the time of the study. Exclusion criteria included: severe valve stenosis or regurgitation, recent cardioversion within the past three months, antiarrhythmic therapy, previous pulmonary vein isolation or cardiac surgery.
Results: During the study period, 369 patients were analyzed. Of these patients, 180 patients had pathologic PTFV1 (49%) and 41 patients (11%) had advanced IAB. Both changes were present in 16 patients (4%). The differences in left atrial hemodynamics associated with each parameter are presented in Tables 1 and 2.
Conclusion: Advanced IAB indicates a significant alteration in left atrial hemodynamics. In contrast, no relevant association between pathologic PTVF1 and left atrial hemodynamics could be observed in this highly selected patient population. Moreover, the overall high prevalence of abnormal PTFV1 suggests that PTFV1 may not be a specific marker of AtCM. The results suggest that future studies on AtCM should prioritize the presence of advanced IAB instead of PTFV1, which has served as an AtCM marker in previous studies.