QT Dispersion & Left Ventricular Hypertrophy in Essential Hypertensive Patients

  • Dr Sangeeta M Gawali Associate Professor, Department of Physiology, B J Govt Medical College, Pune, India
  • Dr Miss Veena Shriram Assistant Professor, Department of Physiology, B. J. Govt. Medical College, Pune, India
  • Dr V G Jaltade Professor & Head Department of Physiology, SBH GMC, Dhule, India
Keywords: systemic essential hypertension, QT dispersion, left ventricular hypertrophy, left ventricular mass index

Abstract

Background: Left ventricular hypertrophy (LVH) is an important indicator of target organ damage in chronic arterial hypertension. An increased risk for life-threatening arrhythmias and sudden death have been observed in hypertensive patients, associated with either left ventricular hypertrophy (LVH) or prolonged QT interval. Present study was conducted to compare QT dispersion in hypertensive patients with LVH & without LVH.

Methods: Forty male subjects affected by essential hypertension with & without LVH, underwent 12 lead ECG recording for QT dispersion and 2D echocardiography performed to measure interventricular septal thickness, posterior wall thickness and left ventricular internal diameter & compared with normal age & sex matched control.

Results: There was statistically significant increase in QT dispersion (p<0.05) in hypertensive subjects with LVH as compared to non-LVH group. Multivariate analysis demonstrated significant relationship between QT dispersion and systolic, diastolic & mean blood pressure, Left ventricular mass & Left ventricular mass index.

Conclusion: Sympatho-vagal imbalance in hypertensive patients with LVH could contribute to abnormal ventricular repolarization process leading to prolongation of QT dispersion. Manual measurement of QT dispersion might be a simple, non-invasive screening procedure to identify the hypertensive at greatest risk of sudden cardiac death.

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References

1. Oikarinen L, Nieminen MS, Viitasalo M, Toivonen L, Sverker J, Dahlo¨f B, Devereux RB, Okin PM. QRS Duration and QT Interval Predict Mortality in Hypertensive Patients With Left Ventricular Hypertrophy. Hypertension. 2004;43:1029-1034.

2. Passinoa C, Franzonib F, Gabuttib A, Polettia R, Galettab F, Emdina M. Abnormal ventricular repolarization in hypertensive patients: role of sympatho-vagal imbalance and left ventricular hypertrophy. International Journal of Cardiology .2004; 97: 57– 623.

3. Cohen A, Hagan AD, J Watkins J, Mitas J, Schvartzman M, Mazzoleni A, Cohen IM, Warren SE, Vieweg WV. Clinical correlates in hypertensive patients with left ventricular hypertrophy diagnosed with echocardiography. Am J Cardlol 1981;47:335-41

4. Passino C, Magagna A, Conforti F, Buralli S, Kozáková M, Palombo C, Emdin M. Ventricular repolarization is prolonged in nondipper hypertensive patients: role of left ventricular hypertrophy and autonomic dysfunction. J Hypertens 2003; 21(2): 445– 51.

5. Schwartz PJ, Wolf S. QT interval prolongation as predictor of sudden death in patients with myocardial infarction. Circulation 1978;57:1074–7.

6. Pewsner D, Ju¨ni P, Egger M, Battaglia M, Sundstrom J, Bachmann LM. Accuracy of electrocardiography in diagnosis of left ventricular hypertrophy in arterial hypertension: systematic review . BMJ 2007 october 6;355(7622):711

7. Forissier JF, Charron P, Montcel SJD, Hagege A, Isharad R, Carrier L, Richard P, Desnos M, Bouhar JB, Schwartz K, Komajda M, Dubourg O. Diagnostic accuracy of a 2D left ventricle hypertrophy score for familial hypertrophic cardiomyopathy. European Heart Journal. 2005; 26(18): 1882–1886.

8. Grassi G. Role of the sympathetic nervous system in human hypertension. J Hypertens, 1998;16:1979–87.

9. Bexton RS, Vallin HO, Camm AJ. Diurnal variation of the QT interval—influence of the autonomic nervous system. Br Heart J. 1986; 55: 126-30.

10. Shouten EG, Dekker JM, Meppelink P, Kok FJ, Vandenbroucke JP. QT interval prolongation predicts cardiovascular mortality in an apparently healthy population. Circulation. 1991 Oct;84(4):1516– 23.

11. Oikarinen L, Nieminen MS, Viitasalo M, Toivonen L, Wachtell K, Papademetriou V. Relation of QT interval and QT dispersion to echocardiographic left ventricular hypertrophy and geometric pattern in hypertensive patients. The LIFE study. J Hypertens. 2001;19:1883–91.

12. Xiao HB, Brecker SJ, Gibson DG. Relative effects of left ventricular mass and conduction disturbance on activation in patients with pathological left ventricular hypertrophy. Br Heart J. 1994 June;71(6):548– 53.

13. James MA, MacConnell TJ, Jones JV. Is ventricular wall stress rather than left ventricular hypertrophy an important contributory factor to sudden cardiac death? Clin Cardiol. 1995;18:61–5.

14. Kleiman RB, Houser SR. Outward currents in normal and hypertrophied ventricular myocytes. Am J Physiol. 1989;256:1450– 61.

15. Cooper R,Rotimi C.Hypertension in blacks. Am J Hypertens.1997;10:804-12

16. Mayet J, Shahi M, McGrath K, Poulter NR,Sever PS,Foale RA, Thome SA. Left ventricular hypertrophy and QT dispersion in hypertension. Hypertension. 1996 Nov;28(5): 791-6.

17. Cooklin M, Wallis WR, Sheridan DJ, Fry CH. Changes in cell-to-cell electrical coupling associated with left ventricular hypertrophy. Circ Res 1997 June; 80(6):765–771

18. McIntyre H, Fry CH. Abnormal action potential conduction in isolated human hypertrophied left ventricular myocardium. J Cardiovasc Electrophysiol.1997 Aug;8(8) :887–894.

19. Drayer JIM, Weber MA, Gardin JM, Lipson JL. Effect of long-term antihypertensive therapy on cardiac anatomy in patients with essential hypertension. Am J Med. 1983;78:116-120.

20. Anversa, E. Puntillo, Niktin P, Olivetti G, Capasso JM. Cellular and mechanical adaptations in cardiac hypertrophy and its reversal. Cardiovascular Reviews and Reports. 1990; 11: 34–41.
CITATION
DOI: 10.17511/ijmrr.2013.i03.02
Published: 2013-08-31
How to Cite
1.
M Gawali S, Shriram V, Jaltade VG. QT Dispersion & Left Ventricular Hypertrophy in Essential Hypertensive Patients. Int J Med Res Rev [Internet]. 2013Aug.31 [cited 2024Nov.8];1(3):76-3. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/13
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Original Article