Left ventricular hypertrophy and QT dispersion in hypertension
Left ventricular hypertrophy and QT dispersion in hypertension
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DOI：
10.1161/01.hyp.28.5.791
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发表时间：
1996-11-01
期刊：
影响因子：
8.3
通讯作者：
Thom, SAM
中科院分区：
文献类型：
--
作者：
Mayet, J;Shahi, M;Thom, SAM
标准心电图上QT间期长度的变化反映了心脏局部复极的差异。为了研究这种导联间变异（QT离散度）与左心室肥厚之间的关系，我们对100名未经治疗的受试者进行了12导联心电图和超声心动图检查。此外，24名先前未接受治疗的受试者接受了雷米普利和非洛地平6个月的治疗研究。在横断面研究的一部分,QT色散修正为心率色散(高职院校学前教育专业)和左心室质量指数显著相关(P < . 01), r = .30,收缩压(r = .30, P < . 01),峰值流速之比早期的填充波心房波的峰值流速(E / A比值)(r = 22, P = .02点),isovolumic弛豫时间(P < . 01), r =。31,和年龄(r = . 21, P < .04点)。在研究的治疗部分，经铅调节的QTc弥散度在治疗后从24毫秒下降到19毫秒，在随后的2周药物洗脱期后保持在19毫秒（P < 0.01）。各阶段左室质量指数变化分别为144、121、124 g/m(2) （P < 0.01）。收缩压由175降至144 mm Hg，药物洗脱后再次升高至164 mm Hg （P < 0.01）。E/A比（0.97、1.02、1.02,P = 0.69）和等容松弛时间（111、112、112,P = 0.97）在三个评价点均未发生变化。总之，高血压患者QT离散度增加与左心室质量指数增加有关。雷米普利和非洛地平抗高血压治疗降低了这两个参数。如果QT离散度升高是这组个体猝死的一个预测因子，那么降低QT离散度的重要性是显而易见的。
The interlead variation in QT length on a standard electrocardiograph reflects regional repolarization differences in the heart. To investigate the association between this interlead variation (QT dispersion) and left ventricular hypertrophy, we subjected 100 untreated subjects to 12-lead electrocardiography and echocardiography. Additionally, 24 previously untreated subjects underwent a 6-month treatment study with ramipril and felodipine. In the cross-sectional part of the study, QT dispersion corrected for heart rate (QTc dispersion) was significantly correlated with left ventricular mass index (r = .30, P < .01), systolic pressure (r = .30, P < .01), the ratio of peak flow velocity of the early filling wave to peak flow velocity of the atrial wave (E/A ratio) (r = -.22, P = .02), isovolumic relaxation time (r = .31, P < .01), and age (r = .21, P < .04). In the treatment part of the study, lead-adjusted QTc dispersion decreased from 24 to 19 milliseconds after treatment, and after a subsequent 2 weeks of drug washout remained at 19 milliseconds (P < .01). The changes in left ventricular mass index at these stages were 144, 121, and 124 g/m(2) (P < .01). Systolic pressure decreased from 175 to 144 mm Hg and increased again to 164 mm Hg after drug washout (P < .01). The E/A ratio (0.97, 1.02, and 1.02; P = .69) and isovolumic relaxation time (111, 112, and 112; P = .97) remained unchanged through the three assessment points. In conclusion, QT dispersion is increased in association with an increased left ventricular mass index in hypertensive individuals. Antihypertensive therapy with ramipril and felodipine reduced both parameters. If an increased QT dispersion is a predictor of sudden death in this group of individuals, then the importance of its reduction is evident.