Secondary repolarization changes in patients with left ventricular hypertrophy


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Aim. To estimate the detection rate of tension syndrome and nonspecific repolarization changes in patients with arterial hypertension (AH).
Subjects and methods. The electrocardiograms of 234 patients with AH (104 males and 130 females) were analyzed, by taking into account the magnitude of blood pressure (BP) elevation, the degree of an overall cardiovascular risk, the grade of hypertensive disease (HD), the presence of coronary heart disease (CHD), as well as echocardiographic and electrocardiographic voltage criteria for left ventricular hypertrophy (LVH).
Results. The classical tension syndrome and nonspecific repolarization changes were observed in 7 and 26% of cases, respectively; no significant differences were found in their detection rates between the males and females. The frequency of repolarization changes were associated with the presence of CHD in the women and with the magnitude of BP elevation, the degree of a cardiovascular risk, the grade of HD, and the presence of both echocardiographic and electrocardiographic signs of LVH.
Conclusion. Ventricular repolarization changes in patients with AH are a sign of severe cardiac lesion and determine the need for meticulous attention.

作者简介

Elena Blinova

Email: eblinova@mtu-net.ru

Galina Ryabykina

Email: ecg.newtekh@gmail.com

Tamara Sakhnova

Email: eblinova@mtu-net.ru

E Blinova

Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

G Ryabykina

Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

T Sakhnova

Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

参考

  1. Rykert H. E., Hepburn J. Electrocardiographic abnormalities characteristic of certain cases of arterial hypertension. Am. Heart J. 1935; 10: 942- 954.
  2. Sokolow M., Lyon T. P. The ventricular complex in left ventricular hypertrophy as obstained by unipolar precordial and limb leads. Am. Heart J. 1949; 37: 161-186.
  3. Reichek N., Devereux R. B. Left ventricular hypertrophy: relationship of anatomic, echocardiographic and electrocardiographic findings. Circulation 1981; 63: 1391-1398.
  4. Levy D., Labib S. B., Andersen K. M. et al. Determinants of sensitivity and specificity of electrocardiographic criteria for left ventricular hypertrophy. Circulation 1990; 81: 815-820.
  5. Carter W. A., Estes E. H. Electrocardiographic manifestations of ventricular hypertrophy: a computer study of ECG anatomic correlations in 319 cases. Am. Heart J. 1964; 68: 173-182.
  6. Devereux R. B., Reichek N. Repolarization abnormalities of left ventricular hypertrophy: clinical, echocardiographic and hemodynamic correlates. J. Electrocardiol. 1982; 15: 47-54.
  7. Okin P. M., Devereux R. B., Nieminen M. S. et al. Relationship of the electrocardiographic strain pattern to left ventricular structure and function in hypertensive patients: the LIFE study. J. Am. Coll. Cardiol. 2001; 38: 514-520.
  8. Ogah O. S., Adebiyi A. A., Oladapo O. O. et al. Association between electrocardiographic left ventricular hypertrophy with strain pattern and left ventricular structure and function. Cardiology 2006; 106 (1): 14-21.
  9. Okin P. M., Devereux R. B., Fabsitz R. R. et al. Quantitative assessment of electrocardiographic left ventricular strain predicts increased left ventricular mass: The Strong Heart Study. J. Am. Coll. Cardiol. 2002; 40: 1395-1400.
  10. Romhilt D. W., Estes E. H. A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am. Heart J. 1968; 75: 752-759.
  11. Schillaci G., Verdecchia P., Borgioni C. et al. Improved electrocardiographic diagnosis of echocardiographic left ventricular hypertrophy. Am. J. Cardiol. 1994; 74: 714-719.
  12. Verdecchia P., Dovellini E. V., Gorini M. et al. Comparison of electrocardiographic criteria for diagnosis of left ventricular hypertrophy in hypertension: the MAVI study. Ital. Heart J. 2000; 1 (3): 207-215.
  13. Kannel W. B., Gordon T., Castelli W. P. et al. Electrocardiographic left ventricular hypertrophy and risk of coronary heart disease: the Framingham Study. Ann. Intern. Med. 1970; 72: 813-822.
  14. Beach C., Kenmure A. C. F., Short D. Electrocardiogram of pure left ventricular hypertrophy and its differentiation from lateral ischemia. Br. Heart J. 1981; 46: 285-289.
  15. Huwez F. U., Pringle S. D., Macfarlane P. W. Variable patterns of ST-T abnormalities in patients with left ventricular hypertrophy and normal coronary arteries. Br. Heart J. 1992; 67: 304-307.
  16. Hancock E. W., Deal B. J., Mirvis D. M. et al. AHA/ACCF/ HRS recommendations for the standardization and interpretation of the electrocardiogram: part V: electrocardiogram changes associated with cardiac chamber hypertrophy: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology, the American College of Cardiology Foundation, and the Heart Rhythm Society. J. Am. Coll. Cardiol. 2009; 53: 992-1002.
  17. Диагностика и лечение артериальной гипертензии. Российские рекомендации (третий пересмотр). Москва 2008 г. Кардиоваск. тер. и профилакт. 2008; 7 (6): Прил. 2.
  18. Ogah O. S., Oladapo O. O., Adebiyi A. A. et al. Electrocardiographic left ventricular hypertrophy with strain pattern: prevalence, mechanisms and prognostic implications. Cardiovasc. J. Afr. 2008; 19 (1): 39-45.
  19. da Costa W., Riera A. R., da Costa F. A. et al. Correlation of electrocardiographic left ventricular hypertrophy criteria with left ventricular mass by echocardiogram in obese hypertensive patients. J. Electrocardiol. 2008; 41 (6): 724-729.
  20. Ochi H., Noda A., Miyata S. et al. Sex differences in the relationships between electrocardiographic abnormalities and the extent of left ventricular hypertrophy by echocardiography. Ann. Noninvasive Electrocardiol. 2006. 11 (3): 222-229.
  21. Sokolov M., Perloff D. The prognosis of essential hypertension treated conservatively. Circulation 1961; 33: 697-713.
  22. Verdecchia P., Schillaci G., Borgioni C. et al. Prognostic value of a new electrocardiographic method for diagnosis of left ventricular hypertrophy. J. Am. Coll. Cardiol. 1998; 31: 383-390.
  23. Kannel W. B., Gordon T., Offutt D. Left ventricular hypertrophy by electrocardiogram: prevalence, incidence, and mortality in the Framingham Study. Ann. Intern. Med. 1969; 71: 89- 105.
  24. Sundström J., Lind L., Ärnlöv J. et al. Echocardiographic and electrocardiographic diagnoses of left ventricular hypertrophy predict mortality independently of each other in a population of elderly men. Circulation 2001; 103: 2346-2351.
  25. Larsen C. T., Dahlin J., Blackburn H. et al. Prevalence and prognosis of electrocardiographic left ventricular hypertrophy, ST segment depression and negative T-wave: the Copenhagen City Heart Study. Eur. Heart J. 2002; 23: 315-324.
  26. Machado D. B., Crow R. S., Boland L. L. et al. Electrocardiographic findings and incident coronary heart disease among participants in the Atherosclerosis Risk in Communities (ARIC) study. Am. J. Cardiol. 2006; 97 (8): 1176-1181.
  27. Kannel W. B. Prevalence and natural history of electrocardiographic left ventricular hypertrophy. Am. J. Med. 1983; 75 (suppl. I): 4-11.
  28. Levy D., Salomon M., D'Agostino R. B. et al. Prognostic implications of baseline elecrocardiographic features and their serial changes in subjects with left ventricular hypertrophy. Circulation 1994; 90: 1786-1793.
  29. 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 (9): 997-1004.
  30. Verdecchia P., Angeli F., Feboldi G. et al. Improved cardiovascular risk stratification by a simple ECG index in hypertension. Am. J. Hypertens. 2003; 16 (8): 646-652.
  31. Hsieh B. P., Pham M. X., Froelicher V. F. Prognostic value of electrocardiographic criteria for left ventricular hypertrophy. Am. Heart J. 2005; 150 (1): 161-167.
  32. Dahlof B., Devereux R. B., Kjeldsen S. E. et al. Cardiovascular morbidity and mortality in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet 2002; 359: 995-1003.
  33. Okin P. M., Devereux R. B., Nieminen M. S. et al. Electrocardiographic strain pattern and prediction of cardiovascular morbidity and mortality in hypertensive patients. Hypertension 2004; 44: 48-54.
  34. Salles G., Cardoso C., Nogueira A. R. et al. Importance of the electrocardiographic strain pattern in patients with resistant hypertension. Hypertension 2006; 48 (3): 437-442.
  35. Okin P. M., Devereux R. B.,Nieminen M. S. et al. Electrocardiographic strain pattern and prediction of new-onset congestive heart failure in hypertensive patients: the Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) study. Circulation 2006; 113: 67-73.
  36. Okin P. M., Wachtell K., Devereux R. B. et al. Combination of the electrocardiographic strain pattern and albuminuria for the prediction of new-onset heart failure in hypertensive patients: the LIFE study. Am. J. Hypertens. 2008; 21 (3): 273-279.
  37. Pringle S. D., Macfarlane P. W., McKillop J. H. et al. Pathophysiologic assessment of left ventricular hypertrophy and strain in asymptomatic patients with essential hypertension. J. Am. Coll. Cardiol. 1989; 13 (6): 1377-1381.
  38. Picano E. The alternative "ischemic" cascade in coronary microvascular disease. Cardiologia 1999; 44 (9): 791-795.
  39. Motz W., Scheler S., Strauer B. E. Coronary microangiopathy in hypertensive heart disease: pathogenesis, diagnosis and therapy. Herz 1995; 20 (6): 355-364.
  40. Li X. Y., Li R., Yu W. et al. Differences in coronary microvascular lesions in coronary heart disease and hypertension: an autopsy study of elderly patients. Chin. Med. J. (Engl.) 2004; 117 (2): 207-212.
  41. Palmieri V., Okin P. M., Bella J. N. et al. Electrocardiographic strain pattern and left ventricular diastolic function in hypertensive patients with left ventricular hypertrophy: the LIFE study. J. Hypertens. 2006; 24 (10): 2079-2084.
  42. Marionneau C., Brunet S., Flagg T. P. et al. Distinct cellular and molecular mechanisms underlie functional remodeling of repolarizing K+ currents with left ventricular hypertrophy. Circ. Res. 2008; 102 (11): 1406-1415.

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