Int J Med Sci 2012; 9(1):93-102. doi:10.7150/ijms.9.93 This issue

Research Paper

Electrocardiographic Findings in Patients with Polycythemia Vera

Mehmet Kayrak1, Kadir Acar2, Enes Elvin Gul1✉, Turyan Abdulhalikov1, Murat Bağlıcaklıoğlu3, Osman Sonmez4, Zeynettin Kaya1, Hatem Arı1

1. Department of Cardiology, Meram School of Medicine, Selcuk University, Konya, Turkey.
2. Department of Hematology, Gazi Medical School, Gazi University, Ankara, Turkey.
3. Department of Internal Medicine, Meram School of Medicine, Selcuk University, Konya, Turkey.
4. Bezmialem University, Faculty of Medicine, Cardiology Department, Istanbul, Turkey.

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Kayrak M, Acar K, Gul EE, Abdulhalikov T, Bağlıcaklıoğlu M, Sonmez O, Kaya Z, Arı H. Electrocardiographic Findings in Patients with Polycythemia Vera. Int J Med Sci 2012; 9(1):93-102. doi:10.7150/ijms.9.93. Available from

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Background: The 12-lead surface electrocardiogram (ECG) is a useful tool to predict both atrial and ventricular arrhythmias via P-wave and QT measurements and its derivatives. Polycythemia vera (PV) is a chronic myeloproliferative disorder associated with cardiovascular events. The aim of this study was to assess ECG findings of patients with PV.

Method and materials: Sixty patients with PV (34 male, mean age 58±11 years) and 60 age and gender-matched healthy volunteers were enrolled into the study. From the 12-lead surface ECG, P-wave and both conventional QT measurements and transmyocardial repolarization parameters (Tpeak-Tend interval (Tp-Te) and derivatives) were evaluated digitally by two experienced cardiologists. In addition, a novel parameter, Pi was calculated digitally as the standard deviation of the P-wave duration across the 12 ECG leads.

Results: QT duration and corrected QT interval were significantly longer in the PV group compared to healthy controls (p<0.01 and p<0.01, respectively). The Tp-Te was longer and the Tp-Te/QT ratio was significantly higher in the PV group compared to the controls. P-wave analyses showed that all P-wave parameters including Pmax, Pmin, P dispersion, and Pi were significantly prolonged in PV patients compared to the controls. The increase of both Tp-Te and P max in the PV group was independent of age, BMI, diabetes and hypertension, gender, systolic blood pressure, hemoglobin, hematocrit, left atrial dimension, left ventricular end-diastolic diameter and early deceleration time in a univariate analysis of co-variance model (F=11.097, p=0.001 and F=31.537, p=0.0001, respectively).

Conclusion: The present study demonstrated that PV may be associated with electrocardiographic abnormalities of both atrium and ventricle.

Keywords: Polycythemia Vera, electrocardiographic abnormalities, atrium, ventricle