P波を調べて何か役に立つことあるんですか
心電図のP波のパラメータとして，長さ，軸，形の3種類がある．P波の長さの延長は心房リモデリングを反映し，心房細動や心血管イベントの予測因子となる．形の変化はターミナルフォースの増大やノッチ型P波があり，どちらも心血管イベントと関連することが示されている．動脈硬化性疾患でのP波の変化は，後負荷増大に伴う心房リモデリングを反映する機序が考えられる．今後，高血圧患者や心不全患者などでの心房細動発症や心血管イベントの予後予測，リスク層別化などにP波の測定を役立てたい．...
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| Published in | 心電図 Vol. 45; no. 2; pp. 121 - 126 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本不整脈心電学会
31.07.2025
|
| Subjects | |
| Online Access | Get full text |
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| Abstract | 心電図のP波のパラメータとして，長さ，軸，形の3種類がある．P波の長さの延長は心房リモデリングを反映し，心房細動や心血管イベントの予測因子となる．形の変化はターミナルフォースの増大やノッチ型P波があり，どちらも心血管イベントと関連することが示されている．動脈硬化性疾患でのP波の変化は，後負荷増大に伴う心房リモデリングを反映する機序が考えられる．今後，高血圧患者や心不全患者などでの心房細動発症や心血管イベントの予後予測，リスク層別化などにP波の測定を役立てたい． |
|---|---|
| AbstractList | 心電図のP波のパラメータとして，長さ，軸，形の3種類がある．P波の長さの延長は心房リモデリングを反映し，心房細動や心血管イベントの予測因子となる．形の変化はターミナルフォースの増大やノッチ型P波があり，どちらも心血管イベントと関連することが示されている．動脈硬化性疾患でのP波の変化は，後負荷増大に伴う心房リモデリングを反映する機序が考えられる．今後，高血圧患者や心不全患者などでの心房細動発症や心血管イベントの予後予測，リスク層別化などにP波の測定を役立てたい． |
| Author | 甲谷, 友幸 |
| Author_xml | – sequence: 1 fullname: 甲谷, 友幸 organization: 自治医科大学内科学講座循環器内科・成人先天性心疾患センター |
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| ContentType | Journal Article |
| Copyright | 2008, Japan Science and Technology Agency |
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| DOI | 10.5105/jse.45.121 |
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| References | 2) Magnani JW, Zhu L, Lopez F, et al. : P-wave indices and atrial fibrillation : cross-cohort assessments from the Framingham Heart Study（FHS）and Atherosclerosis Risk in Communities（ARIC）study. Am. Heart J, 2015 ; 169 : 53-61. e1 6) Perez MV, Dewey FE, Marcus R, et al. : Electrocardiographic predictors of atrial fibrillation. Am Heart J, 2009 ; 158 : 622-628 15) Schnabel RB, Haeusler KG, Healey JS, et al. : Searching for atrial fibrillation poststroke : A white paper of the AF-SCREEN international collaboration. Circulation, 2019 ; 140 : 1834-1850 12) Josephson ME, Kastor JA, Morganroth J : Electrocardiographic left atrial enlargement. Electrophysiologic, echocardiographic, and hemo-dynamic correlates. Am J Cardiol, 1977 ; 39 : 967 9) De Bacquer D, Willekens J, De Backer G : Long-term prognostic value of P-wave characteristics for the development of atrial fibrillation in subjects aged 55 to 74 years at baseline. Am J Cardiol, 2007 ; 100 : 850-854 18) Kabutoya T, Kario K : P-wave changes as an index of hypertensive organ damage and a predictor of cardiovascular events : can the P wave be used to assess atrial reverse remodeling? Hypertens Res, 2022 ; 45 : 1400-1403 16) Lin CY, Lin YJ, Chen YY, et al. : Prognostic significance of premature atrial complexes burden in prediction of long-term outcome. J Am Heart Assoc, 2015 ; 4 : e002192 7) Maheshwari A, Norby FL, Soliman EZ, et al. : Abnormal P-wave axis and ischemic stroke : The ARIC Study（Atherosclerosis Risk In Communities）. Stroke, 2017 ; 48 : 2060-2065 5) Zhou J, Li A, Tan M, et al. : P-wave durations from automated electrocardiogram analysis to predict atrial fibrillation and mortality in heart failure. ESC Heart Fail, 2023 ; 10 : 872-883 4) Yokota A, Kabutoya T, Hoshide S, et al. : Automatically assessed P-wave predicts cardiac events independently of left atrial enlargement in patients with cardiovascular risks : The Japan Morning Surge-Home Blood Pressure Study. J Clin Hypertens（Greenwich）, 2021 ; 23 : 301-308 17) Kabutoya T, Imai Y, Ishikawa S, et al. : Association between P wave polarity in atrial premature complexes and cardiovascular events in a community-dwelling population. BMJ Open, 2020 ; 10 : e033553 14) Kabutoya T, Hoshide S, Kario K : Notched P-wave on digital electrocardiogram predicts cardiovascular events in patients with cardiovascular risks : The Japan Morning Surge Home Blood Pressure（J-HOP）Study. Cardiology, 2022 ; 147 : 307-314 10) Kaykha A, Myers J, Desser KB, et al. : The prognostic importance of isolated P-Wave abnormalities. Clin Cardiol, 2010 ; 33 : E87-93 11) Maheshwari A, Norby FL, Soliman EZ, et al. : Association of P-wave abnormalities with sudden cardiac and cardiovascular death : The ARIC study. Circ Arrhythm Electrophysiol, 2021 ; 14 : e009314 3) Ha LD, Grober AF, Hock J, et al. : Electrocardiographic left atrial abnormalities predict cardiovascular mortality. J Electrocardiol, 2018 ; 51 : 652-657 1) Soliman EZ, Prineas RJ, Case LD, et al. : Ethnic distribution of ECG predictors of atrial fibrillation and its impact on understanding the ethnic distribution of ischemic stroke in the Atherosclerosis Risk in Communities（ARIC）study. Stroke, 2009 ; 40 : 1204-1211 8) Dhaliwal KK, Upadhya B, Soliman EZ, et al. : Association of P-wave axis with incident atrial fibrillation in diabetes mellitus（from the ACCORD Trial）. Am J Cardiol 2020 ; 128 : 191-195 13) Kabutoya T, Ishikawa S, Ishikawa J, et al. : P-wave morphologic characteristics predict cardiovascular events in a community-dwelling population. Ann Noninvasive Electrocardiol, 2012 ; 17 : 252-259 19) Kabutoya T, Kario K : The roles of electrocardiography and self-screening in the early detection of atrial fibrillation in hypertensive patients. Hypertens Res, 2024 ; 47 : 197-199 |
| References_xml | – reference: 14) Kabutoya T, Hoshide S, Kario K : Notched P-wave on digital electrocardiogram predicts cardiovascular events in patients with cardiovascular risks : The Japan Morning Surge Home Blood Pressure（J-HOP）Study. Cardiology, 2022 ; 147 : 307-314 – reference: 7) Maheshwari A, Norby FL, Soliman EZ, et al. : Abnormal P-wave axis and ischemic stroke : The ARIC Study（Atherosclerosis Risk In Communities）. Stroke, 2017 ; 48 : 2060-2065 – reference: 11) Maheshwari A, Norby FL, Soliman EZ, et al. : Association of P-wave abnormalities with sudden cardiac and cardiovascular death : The ARIC study. Circ Arrhythm Electrophysiol, 2021 ; 14 : e009314 – reference: 10) Kaykha A, Myers J, Desser KB, et al. : The prognostic importance of isolated P-Wave abnormalities. Clin Cardiol, 2010 ; 33 : E87-93 – reference: 15) Schnabel RB, Haeusler KG, Healey JS, et al. : Searching for atrial fibrillation poststroke : A white paper of the AF-SCREEN international collaboration. Circulation, 2019 ; 140 : 1834-1850 – reference: 16) Lin CY, Lin YJ, Chen YY, et al. : Prognostic significance of premature atrial complexes burden in prediction of long-term outcome. J Am Heart Assoc, 2015 ; 4 : e002192 – reference: 12) Josephson ME, Kastor JA, Morganroth J : Electrocardiographic left atrial enlargement. Electrophysiologic, echocardiographic, and hemo-dynamic correlates. Am J Cardiol, 1977 ; 39 : 967 – reference: 6) Perez MV, Dewey FE, Marcus R, et al. : Electrocardiographic predictors of atrial fibrillation. Am Heart J, 2009 ; 158 : 622-628 – reference: 3) Ha LD, Grober AF, Hock J, et al. : Electrocardiographic left atrial abnormalities predict cardiovascular mortality. J Electrocardiol, 2018 ; 51 : 652-657 – reference: 8) Dhaliwal KK, Upadhya B, Soliman EZ, et al. : Association of P-wave axis with incident atrial fibrillation in diabetes mellitus（from the ACCORD Trial）. Am J Cardiol 2020 ; 128 : 191-195 – reference: 2) Magnani JW, Zhu L, Lopez F, et al. : P-wave indices and atrial fibrillation : cross-cohort assessments from the Framingham Heart Study（FHS）and Atherosclerosis Risk in Communities（ARIC）study. Am. Heart J, 2015 ; 169 : 53-61. e1 – reference: 1) Soliman EZ, Prineas RJ, Case LD, et al. : Ethnic distribution of ECG predictors of atrial fibrillation and its impact on understanding the ethnic distribution of ischemic stroke in the Atherosclerosis Risk in Communities（ARIC）study. Stroke, 2009 ; 40 : 1204-1211 – reference: 13) Kabutoya T, Ishikawa S, Ishikawa J, et al. : P-wave morphologic characteristics predict cardiovascular events in a community-dwelling population. Ann Noninvasive Electrocardiol, 2012 ; 17 : 252-259 – reference: 18) Kabutoya T, Kario K : P-wave changes as an index of hypertensive organ damage and a predictor of cardiovascular events : can the P wave be used to assess atrial reverse remodeling? Hypertens Res, 2022 ; 45 : 1400-1403 – reference: 19) Kabutoya T, Kario K : The roles of electrocardiography and self-screening in the early detection of atrial fibrillation in hypertensive patients. Hypertens Res, 2024 ; 47 : 197-199 – reference: 5) Zhou J, Li A, Tan M, et al. : P-wave durations from automated electrocardiogram analysis to predict atrial fibrillation and mortality in heart failure. ESC Heart Fail, 2023 ; 10 : 872-883 – reference: 9) De Bacquer D, Willekens J, De Backer G : Long-term prognostic value of P-wave characteristics for the development of atrial fibrillation in subjects aged 55 to 74 years at baseline. Am J Cardiol, 2007 ; 100 : 850-854 – reference: 17) Kabutoya T, Imai Y, Ishikawa S, et al. : Association between P wave polarity in atrial premature complexes and cardiovascular events in a community-dwelling population. BMJ Open, 2020 ; 10 : e033553 – reference: 4) Yokota A, Kabutoya T, Hoshide S, et al. : Automatically assessed P-wave predicts cardiac events independently of left atrial enlargement in patients with cardiovascular risks : The Japan Morning Surge-Home Blood Pressure Study. J Clin Hypertens（Greenwich）, 2021 ; 23 : 301-308 |
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| Title | P波を調べて何か役に立つことあるんですか |
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