Ciobanu A, Gheorghe G S, Ababei M, Deaconu M, Ilieşiu A M, Bolohan M, Păun N, Nicolae C, Nanea I T
"Theodor Burghele" Clinical Hospital, Bucharest, Romania.
"Theodor Burghele" Clinical Hospital, Bucharest, Romania ; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
J Med Life. 2014 Oct-Dec;7(4):545-50.
Hypertension associates with sudden cardiac death, its relationship with ventricular arrhythmias being demonstrated by multiple studies, an increased dispersion of repolarization being an important arrhythmogenesis mechanism. Only a small percentage of hypertensive patients presents increased blood pressure values exclusively as risk factor, most of them presenting additional risk factors that reinforce each other leading to increased total cardiovascular risk.
to analyze the dispersion of repolarization parameters (QT interval, QT dispersion, Tpeak-Tend interval (Tpe), Tpe/QT, Tpe dispersion) in relation to cardiovascular risk factors, as well as total cardiovascular risk estimated by SCORE model, in mild to moderate essential hypertension.
62 consecutive patients, mean age 55±11 years, were evaluated by 24 hours Holter electrocardiography monitoring. Manual measurement of dispersion of repolarization parameters was performed.
Based on SCORE model, 33.9% patients presented low risk, 40.3% moderate risk, 16.1% high risk and 9.1% very high risk. Age had a positive correlation with QT and reverse correlations with QT dispersion, Tpe and Tpe/QT in lead V1. Tpe/QT showed significantly higher values in men versus women. Glucose metabolism disorders associated with higher values of QT and Tpe dispersion were present. However, dispersion of repolarization parameters was similar between risk categories assessed by SCORE model, Tpe in lead V3 correlated significantly with SCORE score.
In mild to moderate hypertension, the dispersion of repolarization parameters is influenced by age, gender and glucose metabolism disorders. Among these, Tpe in lead V3 correlates with total cardiovascular risk assessed by SCORE model.
高血压与心源性猝死相关，多项研究证实了其与室性心律失常的关系，复极离散度增加是重要的心律失常发生机制。只有一小部分高血压患者仅将血压升高作为危险因素，大多数患者还存在其他相互强化的危险因素，导致心血管总风险增加。
分析轻至中度原发性高血压患者复极参数（QT间期、QT离散度、T峰 - T末间期（Tpe）、Tpe/QT、Tpe离散度）与心血管危险因素以及SCORE模型估计的心血管总风险之间的关系。
对62例连续患者（平均年龄55±11岁）进行24小时动态心电图监测评估。手动测量复极参数的离散度。
根据SCORE模型，33.9%的患者为低风险，40.3%为中度风险，16.1%为高风险，9.1%为极高风险。年龄与QT呈正相关，与V1导联的QT离散度、Tpe和Tpe/QT呈负相关。男性的Tpe/QT值显著高于女性。存在与较高QT值和Tpe离散度相关的糖代谢紊乱。然而，SCORE模型评估的不同风险类别之间复极参数的离散度相似，V3导联的Tpe与SCORE评分显著相关。
在轻至中度高血压中，复极参数的离散度受年龄、性别和糖代谢紊乱的影响。其中，V3导联的Tpe与SCORE模型评估的心血管总风险相关。
