{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:33:08Z","timestamp":1772253188740,"version":"3.50.1"},"reference-count":37,"publisher":"Sociedade Brasileira de Cardiologia","issue":"10","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  A cardiomiopatia atrial abrange diversas anormalidades atriais, incluindo a sobrecarga atrial esquerda (SAE), que est\u00e1 associada a desfechos cardiovasculares e neurocognitivos adversos. A dura\u00e7\u00e3o da onda P \u2265 120 ms no eletrocardiograma (ECG) de 12 deriva\u00e7\u00f5es \u00e9 uma ferramenta amplamente dispon\u00edvel e econ\u00f4mica, al\u00e9m de ser um dos principais crit\u00e9rios diagn\u00f3sticos adotados. No entanto, seu desempenho diagn\u00f3stico em estudos de larga escala ainda \u00e9 pouco explorado.  Objetivos  Avaliar a correla\u00e7\u00e3o entre a dura\u00e7\u00e3o da onda P e o volume do \u00e1trio esquerdo (VAE) medido pelo ecocardiograma transtor\u00e1cico (ETT) e determinar a precis\u00e3o diagn\u00f3stica da dura\u00e7\u00e3o da onda P \u2265120 ms para identificar a SAE.  M\u00e9todos  Realizamos uma an\u00e1lise transversal dos dados basais dos participantes da coorte ELSA-Brasil em ritmo sinusal. A dura\u00e7\u00e3o da onda P foi medida automaticamente por meio de ECG padr\u00e3o de 12 deriva\u00e7\u00f5es, com \u2265120 ms indicando sobrecarga atrial. A SAE foi definida como VAE&gt;34 mL\/m2 por ETT. O teste de Spearman avaliou a correla\u00e7\u00e3o. M\u00e9tricas de desempenho diagn\u00f3stico - sensibilidade (Sn), especificidade (Sp), valor preditivo positivo (VPP) e valor preditivo negativo (VPN), raz\u00e3o de verossimilhan\u00e7a positiva e negativa (RV+ e RV-) - foram calculadas. Al\u00e9m disso, foi constru\u00edda uma Curva Caracter\u00edstica de Opera\u00e7\u00e3o do Receptor (ROC). A signific\u00e2ncia estat\u00edstica foi estabelecida em valor de p&lt;0,05 com intervalo de confian\u00e7a de 95%.  Resultados  O estudo incluiu 2.589 participantes, 419 (16,1%) com \u00edndice de VAE &gt; 34 mL\/m2. A dura\u00e7\u00e3o da onda P correlacionou-se fracamente com o VAE (\u03c1 de Spearman = 0,120, p &lt; 0,001). As medidas de acur\u00e1cia diagn\u00f3stica foram: AUC = 0,557 \u00b1 0,032; Se = 0,296; Sp = 0,811; VPP = 0,232; VPN = 0,856; RV + 1,566; RV - 0,868.  Conclus\u00e3o  A dura\u00e7\u00e3o da onda P demonstra valor diagn\u00f3stico limitado para identificar SAE, o que sugere que n\u00e3o \u00e9 recomendado como crit\u00e9rio diagn\u00f3stico isolado para essa condi\u00e7\u00e3o.<\/jats:p>","DOI":"10.36660\/abc.20250151","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T15:32:16Z","timestamp":1767972736000},"source":"Crossref","is-referenced-by-count":0,"title":["Utilidade Diagn\u00f3stica da Dura\u00e7\u00e3o da Onda P na Identifica\u00e7\u00e3o de Sobrecarga Atrial Esquerda: Li\u00e7\u00f5es da Coorte Elsa-Brasil"],"prefix":"10.36660","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7794-8399","authenticated-orcid":false,"given":"Ana Cec\u00edlia de Sena","family":"Oliveira","sequence":"first","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4414-0537","authenticated-orcid":false,"given":"Vinicius Tostes","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6646-1163","authenticated-orcid":false,"given":"Marcelo Martins","family":"Pinto-Filho","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7317-1367","authenticated-orcid":false,"given":"Luisa Caldeira","family":"Brant","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7383-7811","authenticated-orcid":false,"given":"Sandhi Maria","family":"Barreto","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2914-4406","authenticated-orcid":false,"given":"Murilo","family":"Foppa","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2740-0042","authenticated-orcid":false,"given":"Antonio Luiz Pinho","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22636","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"4","key":"ref1","article-title":"P Wave Parameters and Indices: A Critical Appraisal of Clinical Utility, Challenges, and Future Research-A Consensus Document Endorsed by the International Society of Electrocardiology and the International Society for Holter and Noninvasive Electrocardiology","volume":"15","author":"Chen LY","year":"2022","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"9","key":"ref2","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae204","article-title":"Atrial Cardiomyopathy Revisited-Evolution of a Concept: A Clinical Consensus Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asian Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS)","volume":"26","author":"Goette A","year":"2024","journal-title":"Europace"},{"issue":"25","key":"ref3","doi-asserted-by":"crossref","first-page":"3157","DOI":"10.1016\/j.jacc.2017.10.063","article-title":"Structure and Function of the Left Atrium and Left Atrial Appendage: AF and Stroke Implications","volume":"70","author":"Delgado V","year":"2017","journal-title":"J Am Coll Cardiol"},{"issue":"8","key":"ref4","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1161\/01.STR.22.8.983","article-title":"Atrial Fibrillation as an Independent Risk Factor for Stroke: The Framingham Study","volume":"22","author":"Wolf PA","year":"1991","journal-title":"Stroke"},{"issue":"2","key":"ref5","first-page":"206","article-title":"Left Atrial Size and Risk of Stroke in Patients in Sinus Rhythm. 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