Department of Cardiology, Kafkas University School of Medicine, Kars.
Department of Cardiology, Sultan 2. Abdulhamid Khan Educational and Research Hospital.
Blood Press Monit. 2023 Apr 1;28(2):96-102. doi: 10.1097/MBP.0000000000000637. Epub 2023 Feb 17.
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.
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。