Association of altered P wave dispersion and vascular endothelial growth factor in patients with immune-mediated inflammatory diseases

<strong>Background and Aims</strong>: Serum vascular endothelial growth factor (VEGF) levels are elevated and correlate with structural and functional alterations in several immune-mediated inflammatory diseases (IMID). Since P wave dispersion (PWD) is associated with ischemic-related and inflammatory changes in the atrial myocardium, it was conceived that there may be a correlation between altered PWD and increased VEGF levels in IMID patients. <strong>Methods and Results</strong>: In this prospective, observational, analytical, cross-sectional study, 246 patients with immune-mediated inflammatory diseases (IMID group) and 48 subjects without collagen disorders or arterial hypertension (control group) were evaluated. The P wave dispersion was 25.3±4.9 ms in the control group vs. 57±14.9 ms (P&lt;0.0001) in the IMID group. No patient in the control group had altered PWD, defined as ≥38 ms, while 196 (80%) patients in the IMID group presented it (P&lt;0.0001). The serum value of VEGF in IMID patients without altered PWD was 15±21.8 pg/ml vs 39.3±53.6 pg/ml in IMID patients with altered PWD (P&lt;0.03). An elevated VEGF serum value had a specificity of 62.5%, a sensitivity of 65.6%, and a positive predictive value of 95.3% in predicting altered PWD in IMID patients. <strong>Conclusions</strong>: There is a significantly wider P wave duration and PWD in IMID patients than in controls. IMID patients who possess an altered PWD have significantly higher serum levels of VEGF. The presence of an elevated VEGF serum value has a moderate sensitivity and specificity, and a high positive predictive accuracy of the existence of altered P wave dispersion in IMID patients.