Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya30835Changes in orthogonal ECG in hypertensive patients taking different antihypertensive therapySakhnovaTamara Anatol'evnablinova@psk-net.ruBlinovaElena Valentinovnablinova@psk-net.ruRyabykinaGalina Vladimirovnaecg.newtekh@gmail.comShutovaLyudmila Ivanovna-ChikhladzeNovella Mikhaylovnanovella.cardio@mail.ruMartynyukTamara Vital'evna-ChazovaIrina Evgen'evna-SakhnovaT AResearch Cardiology Center, Moscow-BlinovaE VResearch Cardiology Center, Moscow-RyabykinaG VResearch Cardiology Center, Moscow-ShutovaL IResearch Cardiology Center, Moscow-ChikhladzeN MResearch Cardiology Center, Moscow-MartynyukT VResearch Cardiology Center, Moscow-ChazovaI EResearch Cardiology Center, Moscow-Research Cardiology Center, Moscow15042011834394210042020Copyright © 2011, Consilium Medicum2011Aim. To ascertain changes in orthogonal ECG in hypertensive patients taking different antihypertensive treatment.
Material and methods. Orthogonal ECG parameters and those of 24-h blood pressure monitoring (BPM) were examined before and after antihypertensive treatment with different drugs in 95 hypertensive patients aged 47±1 years. Of them, 14 patients received trandolapril+verapamil SR for 2 months, 13 patients - candesartan for 3 months, 25 patients - ramipril for 5 months, 26 patients - carvedilol for 4 months, 10 patients - atenolol for 8 months, 7 patients - doxasozine for 5 months.
Results. 24-h BPM parameters improved in all the groups . Initially, conventional ECG evidence on left ventricular hypertrophy was not seen in 86% patients. Dynamics of orthogonal ECG showed that parameters which increase in left ventricular hypertrophy decrease in response to treatment in patients with baseline values above the median. Parameters G and Gx,which in left ventricular hypertrophy diminish, rise significantly in patients with baseline values under median due to therapy. Treatment with impact on renin-angiotensin system reduced voltage parameters of orthogonal ECG, improved G characterizing repolarisation. Treatment with adrenoreceptors blockers reduced IADI.
Conclusion. The analysis of parameters of orthogonal ECG reveals positive dynamics in response to treatment in patients with insignificant changes on ECG in short follow-up. Drugs of different groups change different parameters of orthogonal ECG.arterial hypertensiontreatmentleft ventricular hypertrophyorthogonal ECG wavesартериальная гипертензиялечениегипертрофия левого желудочкаортогональные отведения ЭКГ[Bender S. R., Devereux R. B., Okin P. M. Risks of electrocardiographic left ventricular hypertrophy in hypertensive individuals and benefits of treatment-induced regression. Curr. Cardiovasc. Risk Rep. 2009; 3: 247-254.][Блинова Е. В., Сахнова Т. А., Саидова М. А. и др. Информативность показателей ортогональной электрокардиограммы в диагностике гипертрофии левого желудочка. Тер. арх. 2007; 4: 15-18.][Диагностика и лечение артериальной гипертонии. Российские рекомендации (третий пересмотр). М.: РМОАГ, ВНОК; 2008.][Сахнова Т. А., Блинова Е. В., Сергакова Л. М. и др. Возможности использования количественных показателей реполяризации в диагностике гипертрофии левого желудочка у больных артериальной гипертонией. Тер. арх. 2009; 4: 13-17.][Okin P. M., Devereux R. B., Jern S. et al. Regression of electrocardiographic left ventricular hypertrophy during antihypertensive treatment and the prediction of major cardiovascular events. J. A. M. A. 2004; 292: 2343-2349.][Verdecchia P., Reboldi G., Angeli F. et al. Prognostic value of serial electrocardiographic voltage and repolarization changes in essential hypertension: the HEART survey study. Am. J. Hypertens. 2007; 20: 997-1004.]