Vilas-Boas F, Lima A A, Torreão J, Feitosa G S
Serviço de Cardiologia do Hospital Aliança, Salvador.
Arq Bras Cardiol. 1997 May;68(5):343-6.
To evaluate QT dispersion in hypertensive patients, with and without left ventricular hypertrophy, and compare with normal persons.
Thirty eight patients (21 male and 17 female, age 55 +/- 15 years) underwent echocardiography and simultaneous 12 lead, vertically aligned, electrocardiogram at 50 mm/s speed. No patient was on antiarrhythmic therapy. There were 19 non-hypertensive patients that constituted the control group (G-I). Group II was constituted by the other 19 patients, who were hypertensives. This group was further divided in group II-A (9 patients without left ventricular hypertrophy) and group II-B (10 patients with left ventricular hypertrophy). QT dispersion was obtained by the difference between the longest and the shortest QT registered.
QT dispersion was significantly increased on hypertensive patients, both with and without left ventricular hypertrophy, when compared to controls (G-I 31 +/- 9 ms, G-II 52 +/- 15 ms. P < 0.0001; G-IIa 46 +/- 10 ms and G-IIb 56 +/- 18 ms X G-I, p < 0.0005). In hypertensive patients, there was no statistically significant difference between group II-A and group II-B.
We conclude that QT dispersion is significantly increased on hypertensive patients when compared to non-hypertensive individuals and that such increase, occurs before left ventricular hypertrophy develops. These findings suggest that, in hypertensive patients, electrical changes in left ventricular myocardium can precede structural and morphological abnormalities. Such findings offer new insights into the mechanisms related to enhanced mortality among hypertensive patients.
评估有或无左心室肥厚的高血压患者的QT离散度,并与正常人进行比较。
38例患者(21例男性,17例女性,年龄55±15岁)接受了超声心动图检查,并同时以50mm/s的速度记录12导联垂直排列的心电图。所有患者均未接受抗心律失常治疗。19例非高血压患者组成对照组(I组)。另外19例高血压患者组成II组。该组又进一步分为II - A组(9例无左心室肥厚患者)和II - B组(10例有左心室肥厚患者)。QT离散度通过记录到的最长QT间期与最短QT间期之差获得。
与对照组相比,有或无左心室肥厚的高血压患者的QT离散度均显著增加(I组31±9ms,II组52±15ms,P<0.0001;II - A组46±10ms,II - B组56±18ms与I组相比,P<0.0005)。在高血压患者中,II - A组和II - B组之间无统计学显著差异。
我们得出结论,与非高血压个体相比,高血压患者的QT离散度显著增加,且这种增加发生在左心室肥厚发展之前。这些发现表明,在高血压患者中,左心室心肌的电变化可先于结构和形态异常出现。这些发现为高血压患者死亡率增加的相关机制提供了新的见解。