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[Late ventricular potentials in left ventricular hypertrophy in patients with stage-II hypertension]
Insights
High-resolution ECG did not significantly aid in diagnosing arrhythmias in hypertension patients with left ventricular hypertrophy. However, low-amplitude signal duration correlated inversely with key echocardiographic measures.
Area of Science:
- Cardiology
- Medical Diagnostics
- Biomedical Engineering
Background:
- Hypertension (stage II) with left ventricular hypertrophy (LVH) poses risks for cardiac arrhythmias.
- Coronary artery atherosclerosis can coexist, complicating diagnosis.
- Assessing arrhythmogenic substrate in these patients requires precise diagnostic tools.
Purpose of the Study:
- To determine the diagnostic value of high-resolution ECG for detecting late ventricular potentials (LVP) in patients with stage II hypertension and LVH.
- To investigate if LVP detection aids in identifying arrhythmogenic substrates, especially in the presence of coronary atherosclerosis.
- To correlate ECG findings with echocardiographic parameters in this patient cohort.
Main Methods:
- Utilized high-resolution ECG for late ventricular potentials (LVP) detection (Simson and Haberl methods).
- Performed echocardiography (echo-CG) and coronary angiography in 63 males with stage II hypertension.
- Analyzed LVP characteristics and their correlation with LVH and coronary artery disease.
Main Results:
- LVP detection rates varied significantly between methods (Simson: 6.3%, Haberl: 0%).
- No significant difference in LVP characteristics was found between patients with and without coronary atherosclerosis.
- A significant inverse correlation was observed between low-amplitude signal duration and echocardiographic measures of LVH (interventricular septum thickness, myocardial mass).
Conclusions:
- High-resolution ECG for LVP detection did not provide additional diagnostic information for arrhythmias in asymptomatic hypertension stage II patients with LVH.
- The inverse correlation between low-amplitude signals and LVH parameters suggests a potential link, but its clinical significance for arrhythmia substrate remains unclear.
- Further research is needed to refine ECG techniques for better risk stratification in hypertensive heart disease.
Aim:
To evaluate diagnostic significance of high-resolution ECG in patients with blood hypertension (BH) stage II with left ventricular hypertrophy (LVH) in the presence or absence of angiographically verified atherosclerosis of the coronary arteries.
Materials And Methods:
ECG (registration of late ventricular potentials by M. Simson and R. Haberl), echo-CG and coronaroventriculography were performed in 63 males with BH stage II.
Results:
Late ventricular potentials (LVP) were detected according to M. Simson in 6.3% of the examinees, while according to R. Haberl in none of them. Duration of filtered complex QRS was normal in all the patients. LVP characteristics were not significantly different in the presence or absence of coronary atherosclerosis. Severe and moderate LVH patients differed significantly by duration of low-amplitude high-frequency signals. An inverse correlation existed between duration of low-amplitude signals in the end of filtered complex QRS and parameters of echo-CG.
Conclusion:
LVP registration both by M. Simson and R. Haberl failed to provide additional information on substrate of the arrhythmia in hypertension stage II patients with LVH free of clinical symptoms of tachyarrhythmia. However, there is an inverse correlation between duration of low-amplitude signals in the end of filtered complex QRS and thickness of interventricular septum, asymmetry index, left ventricular myocardial mass.