C-reactive protein and P-wave in hypertensive patients after conversion of atrial fibrillation

Abstract

P maximum/P dispersion and high-sensitivity C-reactive protein (hs-C-reactive protein) have been proposed as useful markers for predicting the history and recurrence of atrial fibrillation. We tested the association between hs-C-reactive protein and maximum P-wave duration (P maximum)/P-wave dispersion (P dispersion) in hypertensive patients after conversion of atrial fibrillation. We enrolled 92 patients. Hs-C-reactive protein was assessed before cardioversion, the 12-lead ECG was recorded immediately after sinus rhythm restoration. At univariate analysis P maximum above 120 ms was associated with male sex (P = 0.0009), body mass index at least 25 kg/m (P = 0.03) and hs-C-reactive protein greater than 0.30 mg/dl (P = 0.0001), and left atrium diameter greater than 40 mm nearly significant (P = 0.05). P dispersion above 40 ms was associated with hs-C-reactive protein greater than 0.30 mg/dl (P = 0.0001) and left atrium diameter greater than 0.40 mm (P = 0.03). P maximum/P dispersion (mean ± SD) was significantly longer in patients with hs-C-reactive protein greater than 0.30 mg/dl compared to patients with hs-C-reactive protein 0.30 mg/dl or less (P = 0.0001 for both). At multivariate analysis P maximum above 120 ms was associated with male sex (P = 0.01) and with hs-C-reactive protein greater than 0.30 mg/dl (P = 0.002), whereas P dispersion above 40 ms was associated only with hs-C-reactive protein greater than 0.30 mg/dl (P = 0.0006). Male sex and hs-C-reactive protein were associated with P maximum above 120 ms; hs-C-reactive protein was also associated with P dispersion above 40 ms in hypertensive patients after conversion of atrial fibrillation. Subclinical inflammation may be associated with delayed/inhomogeneous atrial activation in hypertensive patients affected by atrial fibrillation.