P-wave indices in patients with pulmonary emphysema: do P-terminal force and interatrial block have confounding effects?

International Journal of Chronic Obstructive Pulmonary Disease
Lovely ChhabraD H Spodick


Pulmonary emphysema causes several electrocardiogram changes, and one of the most common and well known is on the frontal P-wave axis. P-axis verticalization (P-axis > 60°) serves as a quasidiagnostic indicator of emphysema. The correlation of P-axis verticalization with the radiological severity of emphysema and severity of chronic obstructive lung function have been previously investigated and well described in the literature. However, the correlation of P-axis verticalization in emphysema with other P-indices like P-terminal force in V1 (Ptf), amplitude of initial positive component of P-waves in V1 (i-PV1), and interatrial block (IAB) have not been well studied. Our current study was undertaken to investigate the effects of emphysema on these P-wave indices in correlation with the verticalization of the P-vector. Unselected, routinely recorded electrocardiograms of 170 hospitalized emphysema patients were studied. Significant Ptf (s-Ptf) was considered ≥40 mm.ms and was divided into two types based on the morphology of P-waves in V1: either a totally negative (-) P wave in V1 or a biphasic (+/-) P wave in V1. s-Ptf correlated better with vertical P-vectors than nonvertical P-vectors (P = 0.03). s-Ptf also significantly corr...Continue Reading


Mar 20, 1999·Clinical Cardiology·R Baljepally, D H Spodick
Aug 15, 2001·Clinical Cardiology·U C Jairath, D H Spodick
Oct 31, 2001·American Heart Journal·S B Goyal, D H Spodick
Sep 11, 2007·The American Journal of Cardiology·Elias GialafosChristodoulos Stefanadis
Feb 11, 2011·The American Journal of Cardiology·Anish J ThomasD H Spodick
Sep 13, 2011·Journal of Electrocardiology·Lovely Chhabra, D H Spodick
Jul 6, 2012·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Lovely ChhabraD H Spodick
Aug 28, 2012·Journal of Electrocardiology·Antonio Bayés de LunaD H Spodick
Feb 5, 2013·International Journal of Chronic Obstructive Pulmonary Disease·Rishi BajajD H Spodick


Dec 3, 2013·International Journal of Chronic Obstructive Pulmonary Disease·Swapnil S LanjewarD H Spodick
Dec 24, 2013·Journal of Electrocardiology·Michelle L SnyderGerardo Heiss
Dec 2, 2015·International Journal of Cardiology·Lovely Chhabra
Sep 24, 2015·International Journal of Cardiology·Goudis A Christos
Aug 25, 2015·International Journal of Cardiology·N Gurukripa Kowlgi, Lovely Chhabra

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