Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Istanbul, Turkey.
Clin Exp Hypertens. 2022 May 19;44(4):2043892. doi: 10.1080/10641963.2022.2043892. Epub 2022 Mar 16.
The frontal QRS-T (fQRST) angle is associated with worse cardiovascular outcome. The study aimed to assess the effect of reverse dipping pattern on f(QRST) angle in newly diagnosed masked hypertensive (MH) patients.
Newly diagnosed 244 consecutive MH patients were included. According to dipping pattern, patients were grouped into three: dipper (n = 114), non-dipper (n = 106), and reverse dipper (n = 24) patterns. The f(QRST) angle, QT and corrected QT interval, and QT dispersion were measured from the 12-lead surface electrocardiogram and compared between groups.
Of all, 51.2% (n = 125) were male. No gender difference was observed. Reverse dipper MH group had a significantly higher f(QRST) angle than the non-dipper and dipper MH groups (77.9 ± 8.6 vs. 32.4 ± 18.8 and 26.0 ± 18.5, respectively, p < .001). The cutoff value for f(QRST) angle of 51 predicts reverse dipping pattern (AUC: 0.84; 95% CI: 0.77-0.90; p < .001), with a sensitivity of 83% and a specificity of 78%.
This study revealed that f(QRST) angle is gradually increased starting from the dipper, non-dipper to reverse dipper masked hypertensives. The f(QRST) angle appears as an easy marker for the detection and risk stratification of hypertensive patients.
额面 QRS-T（fQRST）角与心血管不良预后相关。本研究旨在评估新发隐匿性高血压（MH）患者中反杓型血压模式对 f（QRST）角的影响。
纳入 244 例连续新发 MH 患者。根据血压模式，患者分为三组：杓型组（n=114）、非杓型组（n=106）和反杓型组（n=24）。从 12 导联体表心电图测量 f（QRST）角、QT 和校正 QT 间期以及 QT 离散度，并对各组间进行比较。
共 51.2%（n=125）为男性，无性别差异。反杓型 MH 组的 f（QRST）角明显高于非杓型和杓型 MH 组（77.9±8.6 vs. 32.4±18.8 和 26.0±18.5，均 p<0.001）。f（QRST）角的截断值为 51 预测反杓型血压模式（AUC：0.84；95%CI：0.77-0.90；p<0.001），具有 83%的敏感性和 78%的特异性。
本研究表明，f（QRST）角从杓型、非杓型逐渐增加到反杓型隐匿性高血压。f（QRST）角似乎是一种简单的标志物，可用于检测和分层高血压患者的风险。
