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初诊高血压患者额面 QRS-T 夹角与逆杓型血压的关系。

The association between frontal QRS-T angle and reverse dipper status in newly diagnosed hypertensive patients.

机构信息

Department of Cardiology, Kafkas University School of Medicine, Kars.

Department of Cardiology, Sultan 2. Abdulhamid Khan Educational and Research Hospital.

出版信息

Blood Press Monit. 2023 Apr 1;28(2):96-102. doi: 10.1097/MBP.0000000000000637. Epub 2023 Feb 17.

Abstract

The frontal QRS-T angle (fQRS-T angle) in ECG is a new measure of myocardial repolarization, in which a higher fQRS-T angle is linked with worse cardiac outcomes. Reverse dipper hypertension is also linked to poor cardiac outcomes. The purpose of this study was to investigate the association between the fQRS-T angle and reverse dipper status in individuals newly diagnosed with hypertension who did not have left ventricular hypertrophy (LVH). The investigation recruited 171 hypertensive individuals without LVH who underwent 24-h ambulatory blood pressure monitoring (ABPM). On the basis of the findings of 24-h ABPM, the study population was categorized into the following three groups: patients with dipper hypertension, non-dipper hypertension, and reverse dipper hypertension. LVH was defined by echocardiography. The fQRS-T angle was measured using the 12-lead ECG. The fQRS-T angle in individuals with reverse dipper hypertension was substantially greater than in patients with and without dipper hypertension (51° ± 28° vs. 28° ± 22° vs. 39° ± 25°, respectively, P < 0.001). The fQRS-T angle (odds ratio: 1.040, 95% confidence interval: 1.016-1.066; P = 0.001) was independently associated with reverse dipper hypertension according to multivariate analysis. In receiver operating characteristic curve analysis, the fQRS-T angle to predict reverse dipper hypertension was 33.5° with 76% sensitivity and 71% specificity. This study showed that an increased fQRS-T angle was associated with reverse dipper hypertension in newly diagnosed hypertensive patients without LVH.

摘要

心电图中的额面 QRS-T 角(fQRS-T 角)是一种新的心肌复极测量指标,其中较高的 fQRS-T 角与较差的心脏预后相关。反杓型高血压也与较差的心脏预后相关。本研究旨在探讨新诊断为高血压且无左心室肥厚(LVH)的个体中 fQRS-T 角与反杓型状态之间的相关性。该研究共纳入 171 例接受 24 小时动态血压监测(ABPM)的无 LVH 高血压患者。根据 24 小时 ABPM 的结果,将研究人群分为以下三组:杓型高血压患者、非杓型高血压患者和反杓型高血压患者。LVH 通过超声心动图定义。使用 12 导联心电图测量 fQRS-T 角。反杓型高血压患者的 fQRS-T 角显著大于杓型和非杓型高血压患者(51°±28°比 28°±22°和 39°±25°,分别,P<0.001)。多变量分析显示,fQRS-T 角(比值比:1.040,95%置信区间:1.016-1.066;P=0.001)与反杓型高血压独立相关。在受试者工作特征曲线分析中,fQRS-T 角预测反杓型高血压的截断值为 33.5°,具有 76%的敏感性和 71%的特异性。本研究表明,在新诊断的无 LVH 高血压患者中,fQRS-T 角增加与反杓型高血压相关。

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