左心室肥厚增加高血压患者室性心律失常的发生率

[Left ventricular hypertrophy increases the frequency of ventricular arrhythmia in hypertensive patients].

作者信息

Ozdemir Ayşe, Telli Hasan Hüseyin, Temizhan Ahmet, Altunkeser Bülent B, Ozdemir Kurtuluş, Alpaslan Mete, Karabağ Turgut

机构信息

Department of Cardiology, Meram Medical Faculty, Selçuk University, Konya.

出版信息

Anadolu Kardiyol Derg. 2002 Dec;2(4):293-9.

PMID:12460824

Abstract

OBJECTIVE

To evaluate the relationship between left ventricular hypertrophy (LVH) and geometrical structure of the left ventricle with the risk of arrhythmia and QT dispersion (QTd) in hypertensive patients.

METHODS

Eighty patients were included (mean age 53 +/- 11 years, 45 women) in the study. Among them, concentric LVH was present in 30, concentric remodelling in 15 and normal left ventricular geometry in 35 patients. Twenty-four hours electrocardiographic monitoring and QTd calculation were performed for all patients.

RESULTS

Lown grade 2-3 ventricular arrhythmia was found in 30 patients (37%) and Lown grade 4a-4b ventricular arrhythmia was documented in 17 patients (21%). The frequency of >Lown 2 ventricular arrhythmia in patients with concentric LVH was significantly higher than those of the subjects with concentric remodelling or normal geometry (p<0.01). The percentage of >Lown 2 ventricular arrhythmias were 80% in patients with LVH and 10% in patients without LVH. QT and QTc dispersions in patients with concentric hypertrophy were significantly longer than those of the patients with concentric remodelling and normal geometry. Additionally, QT and QTc dispersions in patients with ventricular arrhythmias were more frequent than in those without (p<0.001). The left ventricular mass index correlated positively both with the QTd and the QTc dispersions (r=0.33, p=0.007, r=0.26, p= 0.03, respectively). The left ventricular mass index also correlated significantly with both grades (Lown 2-3 and Lown 4a-4b) of ventricular arrhythmia (r=0.59, p=0.001; r=0.53, p=0.001, respectively).

CONCLUSION

In hypertensive patients, especially in those with concentric LVH, the incidence of ventricular arrhythmia increases in relation with QT dispersion.

摘要

目的

评估高血压患者左心室肥厚（LVH）及左心室几何结构与心律失常风险和QT离散度（QTd）之间的关系。

方法

本研究纳入80例患者（平均年龄53±11岁，45例女性）。其中，30例存在向心性LVH，15例为向心性重构，35例左心室几何结构正常。对所有患者进行24小时心电图监测及QTd计算。

结果

30例患者（37%）发现Lown 2 - 3级室性心律失常，17例患者（21%）记录到Lown 4a - 4b级室性心律失常。向心性LVH患者中>Lown 2级室性心律失常的发生率显著高于向心性重构或几何结构正常的患者（p<0.01）。LVH患者中>Lown 2级室性心律失常的比例为80%，无LVH患者为10%。向心性肥厚患者的QT和QTc离散度显著长于向心性重构和几何结构正常的患者。此外，有室性心律失常患者的QT和QTc离散度比无室性心律失常患者更常见（p<0.001）。左心室质量指数与QTd和QTc离散度均呈正相关（分别为r = 0.33，p = 0.007；r = 0.26，p = 0.03）。左心室质量指数也与室性心律失常的两个级别（Lown 2 - 3级和Lown 4a - 4b级）均显著相关（分别为r = 0.59，p = 0.001；r = 0.53，p = 0.001）。