Buğra Z, Koylan N, Vural A, Erzengin F, Umman B, Yilmaz E, Meriç M, Büyüköztürk K
Department of Cardiology, Istanbul Faculty of Medicine, University of Istanbul, Türkiye.
Am J Hypertens. 1998 Oct;11(10):1164-70. doi: 10.1016/s0895-7061(98)00144-7.
The spectrum of left ventricular adaptation to hypertension, different types of hypertrophy patterns, and QT dispersion in different types of hypertrophy was investigated in 107 patients with untreated essential hypertension and 30 age- and gender-matched normal adults studied by 12-derivation electrocardiogram (ECG), two-dimensional, and M-mode echocardiography. Left ventricular mass (LVM), body mass index, total peripheral resistance (TPR), relative wall thickness (RWT), and QT dispersion were found to be statistically significantly higher in the hypertension group (P < .001 for all). Among hypertensive patients, 41.1% had both normal LVM and RWT, here called normal left ventricle in hypertension; 10.3% had concentric hypertrophy with increased LVM and RWT; 14.95% had eccentric hypertrophy with increased LVM and normal RWT; and 32.7% had concentric remodeling with normal LVM and increased RWT. Echocardiographically derived cardiac index was higher in the concentric hypertrophy and eccentric hypertrophy patterns (P = .002 and P < .0001, respectively), whereas TPR was higher in the concentric hypertrophy and concentric remodeling patterns (P = .017 and .02, respectively). QT dispersion values were found to be increased in the hypertensive group (P = .001), whereas similar values were calculated for different types of hypertrophy patterns. We conclude that the more common types of ventricular adaptation to essential hypertension are eccentric hypertrophy and concentric remodeling. Concentric hypertrophy is found to be associated with both volume and pressure overload, whereas eccentric hypertrophy is associated with volume overload only and concentric remodeling is associated with pressure overload. But different left ventricular geometric patterns seem to have similar effects on QT dispersion.
通过12导联心电图（ECG）、二维和M型超声心动图，对107例未经治疗的原发性高血压患者和30例年龄及性别匹配的正常成年人进行研究，以探讨左心室对高血压的适应谱、不同类型的肥厚模式以及不同类型肥厚中的QT离散度。结果发现，高血压组的左心室质量（LVM）、体重指数、总外周阻力（TPR）、相对室壁厚度（RWT）和QT离散度在统计学上显著更高（所有P值均＜0.001）。在高血压患者中，41.1%的患者LVM和RWT均正常，在此称为高血压患者的正常左心室；10.3%的患者为向心性肥厚，LVM和RWT增加；14.95%的患者为离心性肥厚，LVM增加而RWT正常；32.7%的患者为向心性重构，LVM正常而RWT增加。超声心动图得出的心脏指数在向心性肥厚和离心性肥厚模式中更高（分别为P = 0.002和P ＜ 0.0001），而TPR在向心性肥厚和向心性重构模式中更高（分别为P = 0.017和0.02）。发现高血压组的QT离散度值增加（P = 0.001），而不同类型的肥厚模式计算出的QT离散度值相似。我们得出结论，原发性高血压最常见的心室适应类型是离心性肥厚和向心性重构。发现向心性肥厚与容量和压力负荷均有关，而离心性肥厚仅与容量负荷有关，向心性重构与压力负荷有关。但不同的左心室几何模式似乎对QT离散度有相似的影响。
