Pringle S D, Dunn F G, Macfarlane P W, McKillop J H, Lorimer A R, Cobbe S M
Department of Medical Cardiology, Glasgow Royal Infirmary, Scotland, United Kingdom.
Am J Cardiol. 1992 Apr 1;69(9):913-7. doi: 10.1016/0002-9149(92)90792-w.
Hypertensive patients with the electrocardiographic (ECG) pattern of left ventricular (LV) hypertrophy and strain are at increased risk of sudden death. It has been suggested that ventricular arrhythmias may be responsible. The prevalence and significance of ventricular arrhythmias was therefore studied in 90 hypertensive patients with LV hypertrophy and strain by undertaking 48-hour ambulatory ECG monitoring, ECG signal-averaging and programmed ventricular stimulation. Complex ventricular ectopic activity (Lown grade greater than or equal to 3) was detected in 59 patients (66%). Eleven patients (12%) had episodes of nonsustained ventricular tachycardia. There were no sustained arrhythmias either on ambulatory ECG monitoring or induced by programmed ventricular stimulation. Only 1 patient had ventricular late potentials recorded by the signal-averaged electrocardiogram. Therefore, there was little to suggest an underlying arrhythmogenic substrate in these patients. In conclusion, whereas ventricular arrhythmias occur often in patients with LV hypertrophy associated with systemic hypertension, their significance, if any, remains to be established.
有左心室肥厚及劳损心电图表现的高血压患者猝死风险增加。有观点认为室性心律失常可能是原因所在。因此，通过48小时动态心电图监测、心电图信号平均及程控心室刺激，对90例有左心室肥厚及劳损的高血压患者的室性心律失常的发生率及意义进行了研究。59例患者（66%）检测到复杂室性异位活动（洛恩分级大于或等于3级）。11例患者（12%）有非持续性室性心动过速发作。动态心电图监测或程控心室刺激均未诱发持续性心律失常。仅1例患者信号平均心电图记录到心室晚电位。因此，几乎没有证据表明这些患者存在潜在的致心律失常基质。总之，虽然与系统性高血压相关的左心室肥厚患者常发生室性心律失常，但其意义（如果有）仍有待确定。
