Dimopoulos Stavros, Nicosia Franco, Donati Paolo, Prometti Paola, De Vecchi Massimiliano, Zulli Roberto, Grassi Vittorio
Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Athens, Greece.
Angiology. 2008 Oct-Nov;59(5):605-12. doi: 10.1177/0003319707310276. Epub 2008 Apr 2.
Inhomogeneity of ventricular repolarization as detected by QT dispersion may be a potential leading mechanism of sudden death in hypertensive and normotensive (age related) left ventricular hypertrophy. Aim of this study was to investigate QT dispersion, ventricular arrhythmias, and left ventricular mass index in elderly hypertensive and normotensive patients. Study population consisted of 60 consecutive patients (sex: 34 men/26 women; age: 63 +/- 11 years) with essential arterial hypertension and 48 age and sex-matched control subjects (24 men/24 women; 64 +/- 16 years). Measurements included QTc dispersion, ventricular arrhythmias, and left ventricular hypertrophy. Hypertensive patients had greater left ventricular mass index (P = .006) and higher QTc dispersion (P = .004) than controls. Left ventricular hypertrophy was diagnosed in 57 (31 men/26 women) of all subjects. These patients had higher blood pressure (P < .05), Lown's score (P < .001), and QTc dispersion (P < .001). QTc dispersion and Lown's score were independent predictors of left ventricular mass index (P < .001). Conclusively, QTc dispersion is a strong indicator of left ventricular mass index and might be used in risk stratification of hypertensive and normotensive elderly patients.
通过QT离散度检测到的心室复极不均匀性可能是高血压和血压正常(与年龄相关)的左心室肥厚患者猝死的潜在主要机制。本研究的目的是调查老年高血压和血压正常患者的QT离散度、室性心律失常和左心室质量指数。研究人群包括60例连续的原发性高血压患者(性别:34例男性/26例女性;年龄:63±11岁)和48例年龄及性别匹配的对照受试者(24例男性/24例女性;64±16岁)。测量指标包括校正QT离散度、室性心律失常和左心室肥厚。高血压患者的左心室质量指数(P = 0.006)和校正QT离散度(P = 0.004)均高于对照组。所有受试者中有57例(31例男性/26例女性)被诊断为左心室肥厚。这些患者的血压(P < 0.05)、洛恩评分(P < 0.001)和校正QT离散度(P < 0.001)更高。校正QT离散度和洛恩评分是左心室质量指数的独立预测因素(P < 0.001)。总之,校正QT离散度是左心室质量指数的一个强有力指标,可用于高血压和血压正常老年患者的风险分层。