Identifying early left atrial dysfunction in COPD patients using ECG morphology-voltage-P wave duration score

KÜÇÜK U., MUTLU P., MİRİCİ A., Özpınar U., ÖZPINAR S. B.

Journal of Electrocardiology, vol.88, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 88
  • Publication Date: 2025
  • Doi Number: 10.1016/j.jelectrocard.2024.153854
  • Journal Name: Journal of Electrocardiology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL
  • Keywords: 12‑lead electrocardiogram, Left atrial function, Strain echocardiography
  • Çanakkale Onsekiz Mart University Affiliated: Yes

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is associated with left atrial (LA) dyfunction, which may contribute to adverse cardiovascular outcomes. This study investigates the predictive value of lately identified morphology-voltage-P wave duration electrocardiography (MVP ECG) score for detecting early LA dysfunction in COPD patients. Methods: In this cross-sectional study, 101 COPD patients were enrolled. All patients underwent speckle tracking echocardiography and were classified into two groups based on their LA functions. Results: Our findings demonstrate significant variations in Peak Atrial Longitudinal Strain (PALS) values among COPD patients, with a mean PALS of 28.74 ± 1.81 % for the group with normal LA function and 18.44 ± 1.87 % for the group with abnormal LA function (p < 0.001). Despite similar LA diameters across groups, these variations indicate subclinical LA pathogenesis. ROC curve analysis indicated that an MVP ECG score greater than 2.5 predicted abnormal LA function with a sensitivity of 65 % and a specificity of 91 % (area under the curve [AUC]: 0.873; p < 0.001), suggesting its utility in identifying atrial damage and remodeling. Conclusions: The MVP ECG score shows promise as a tool for early detection of atrial remodeling in COPD patients.