Naser Nabil, Pepic Esad, Avdic Sevleta
Polyclinic "Dr. Nabil", Sarajevo, Sarajevo, Bosnia and Herzegovina.
Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Acta Inform Med. 2022 Mar;30(1):69-75. doi: 10.5455/aim.2022.30.69-75.
Arrhythmias are common problems in hypertensive patients. The presence and complexity of both supraventricular and ventricular arrhythmias may influence morbidity, mortality, as well as the quality of life of patients.
The aim of this study was to assess the diagnostic value of combined 24h BP and ECG Holter monitoring in detection of cardiac arrhythmias in patients with arterial hypertension.
We analyzed the simultaneous records of combined 24h BP and ECG Holter monitoring for 356 adult patients with diagnosed arterial hypertension in the period from January 2017 until January 2021 year. The cardiac arrhythmias were classified in three main groups as following: a) Supraventricular arrhythmias; b) Ventricular arrhythmias; c) Bradyarrhythmia's. Standard transthoracic echocardiograms were performed in order to evaluate signs of hypertensive or structural heart disease with focus on left ventricle hypertrophy and LV function.
Patients had a mean age of 64 ± 11years, 62% male. Average clinic BP was 153.4+18/87.5+14 mmHg. More than 46% of patients displayed a very high-risk profile. In all enrolled patients, cardiac arrhythmia was detected in 302 (84%) patients. The total number of patients with supraventricular arrhythmias was 153 (50,7%). Ventricular arrhythmias were detected in 98 (32,5%) patients. Bradyarrhythmia's were detected in 51 (16,9%) patients. Elevated resting heart rate in sinus rhythm was detected in 87 (31,6%) of 275 patients with sinus rhythm.
Most arrhythmias are related to longstanding arterial hypertension. Effective treatment of arterial hypertension plays important role in preventing structural and functional cardiac abnormalities which will contribute to the reduction of cardiac arrhythmias in hypertensive patients.
心律失常是高血压患者常见的问题。室上性和室性心律失常的存在及其复杂性可能会影响患者的发病率、死亡率以及生活质量。
本研究旨在评估24小时血压与心电图动态监测相结合在检测动脉高血压患者心律失常方面的诊断价值。
我们分析了2017年1月至2021年1月期间356例确诊为动脉高血压的成年患者的24小时血压与心电图动态监测同步记录。心律失常主要分为三组：a）室上性心律失常；b）室性心律失常；c）缓慢性心律失常。进行标准经胸超声心动图检查以评估高血压或结构性心脏病的体征，重点关注左心室肥厚和左心室功能。
患者的平均年龄为64±11岁，男性占62%。平均诊室血压为153.4+18/87.5+14 mmHg。超过46%的患者表现出极高风险特征。在所有纳入的患者中，302例（84%）检测到心律失常。室上性心律失常患者总数为153例（50.7%）。98例（32.5%）患者检测到室性心律失常。51例（16.9%）患者检测到缓慢性心律失常。在275例窦性心律患者中，87例（31.6%）检测到静息心率升高。
大多数心律失常与长期动脉高血压有关。有效治疗动脉高血压在预防心脏结构和功能异常方面起着重要作用，这将有助于减少高血压患者的心律失常。
