{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:06:51Z","timestamp":1784700411504,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to explore the correlation between the electrical axis of the P wave and lung function indicators in patients with chronic obstructive pulmonary disease (COPD) and the prognostic value of the P wave electrical axis in COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was performed on data from 407 participants at Henan Provincial People\u2019s Hospital, Northeast Henan Hospital. Participants were categorized into control group (\n                      <jats:italic>n<\/jats:italic>\n                      = 206) and COPD group (\n                      <jats:italic>n<\/jats:italic>\n                      = 201). The COPD group was further divided into five subgroups (mild, moderate, moderate-severe, severe, and very severe) according to the percentage of predicted FEV1 (FEV1% pred). The study employed multiple linear and logistic regression analysis, restricted cubic splines (RCS) analysis, and subgroup analyses to examine the correlation between the P wave electrical axis and ventilation indicators.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      COPD patients were older, predominantly male, and had higher smoking prevalence than controls (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). The analysis showed higher heart rate (81.3 \u00b1 16.7 vs. 73.0 \u00b1 12.3 bpm,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) and P-wave axis (64.2 \u00b1 21.9\u00b0 vs. 41.5 \u00b1 18.4\u00b0,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) in COPD patients. Univariate linear regression demonstrated significant negative correlations between P-wave axis and pulmonary function indicators: FEV1 (\u03b2 = \u22129.24,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) and FEF75% (\u03b2 = \u221214.72,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Logistic regression analysis showed that the P-wave axis was independently and positively associated with the risk of COPD (OR = 1.05,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). The RCS analysis further suggests a non-linear pattern \u201cJ-shaped\u201d, between P-wave axis and COPD risk, and beyond a specific threshold, at 61.9\u00b0, risk increased more sharply above this threshold. Notably, the steep upward trend of risk for P-wave axis &amp;gt; 75\u00b0 was limited by sparse sample distribution and only for exploratory reference. Additionally, subgroup analysis indicates a stronger association in males than females (OR = 1.06,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Subgroup results should be interpreted cautiously due to reduced statistical power within small stratified populations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The P-wave axis is closely associated with pulmonary function and COPD risk, exhibiting a nonlinear \u201cJ-shaped\u201d relationship with 61.9\u00b0 (95%CI: 61.5\u00b0, 62.4\u00b0) inflection point.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1860150","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:54:14Z","timestamp":1784699654000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nonlinear association between P-wave axis and lung function in adult population with COPD: evidence from a cross-sectional 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