The Effects of Iron Deficiency Anemia on P Wave Duration and Dispersion

Abstract

OBJECTIVES: The association between P wave dispersion and iron deficiency anemia has not been documented in the literature. In this study, we evaluated P wave dispersion in patients with iron deficiency anemia and the possible relationships between P wave dispersion and other echocardiographic parameters. INTRODUCTION: The iron status of an individual may play an important role in cardiovascular health. Anemia is an independent risk factor for adverse cardiovascular outcomes. P wave dispersion is a simple electrocardiographic marker that has a predictive value for the development of atrial fibrillation. Apart from cardiovascular diseases, several conditions, such as seasonal variation, alcohol intake and caffeine ingestion, have been demonstrated to affect P wave dispersion. METHODS: The study included 97 patients who had iron deficiency anemia and 50 healthy subjects. The cases were evaluated with a clinical examination and diagnostic tests that included 12-lead electrocardiography and transthoracic echocardiography. RESULTS: Compared to the control group, patients with iron deficiency anemia showed significantly longer maximum P wave duration (Pmax) ( 91.1 +/- 18.0 vs. 85.8 +/- 6.7 msec, p = 0.054), P wave dispersion (PWD) (48.1 +/- 7.7 vs. 40.9 +/- 5.6 msec, p < 0.001), mitral inflow deceleration time (DT) (197.5 +/- 27.9 vs. 178.8 +/- 8.9 msec, p < 0.001) and isovolumetric relaxation time (IVRT) (93.3 +/- 9.2 vs. 77.4 +/- 8.2 msec, p < 0.001); they also showed increased heart rate (85.7 +/- 16.1 vs. 69.0 +/- 4.4, p < 0.001) and frequency of diastolic dysfunction (7 (7.2%) vs. 0). Correlation analysis revealed that PWD was significantly correlated with IVRT, DT, heart rate, the presence of anemia and hemoglobin level. CONCLUSIONS: Iron deficiency anemia may be associated with prolonged P wave duration and dispersion and impaired diastolic left ventricular filling.