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Comparison of arrhythmias among different left ventricular geometric patterns in essential hypertension
1Department of Emergency Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030.
Insights
Essential hypertension patients with left ventricular remodeling show higher risks of atrial and ventricular arrhythmias. Specific geometric patterns independently influence arrhythmia severity, even after adjusting for other risk factors.
Area of Science:
- Cardiology
- Hypertension Research
- Electrophysiology
Background:
- Essential hypertension is linked to cardiac structural changes.
- Left ventricular geometric patterns may influence arrhythmia development.
- Understanding these relationships is crucial for risk stratification.
Purpose of the Study:
- To investigate arrhythmias in essential hypertension patients.
- To compare arrhythmia prevalence across different left ventricular geometric patterns.
- To identify independent determinants of arrhythmias.
Main Methods:
- 179 essential hypertension patients underwent 24-hour ECG, blood pressure monitoring, and echocardiography.
- Left ventricular geometric patterns and arrhythmias were identified.
- Statistical analyses, including regression, were used to assess determinants and pattern differences.
Main Results:
- Patients with left ventricular remodeling had significantly higher rates of atrial, ventricular, and complex ventricular arrhythmias.
- Hypertension grade, left atrial dimension, E/A ratio, and nocturnal diastolic blood pressure load were key determinants.
- Arrhythmia severity differences persisted among geometric patterns after adjusting for confounding factors.
Conclusions:
- Left ventricular geometric patterns are significant independent predictors of arrhythmias in essential hypertension.
- Specific structural changes, like remodeling, increase arrhythmia risk.
- Tailored management considering cardiac structure is important for hypertensive patients.
Abstract:
The differences of arrhythmias among distinct left ventricular geometric patterns in the patients with essential hypertension were studied. 179 patients with essential hypertension received 24 h dynamic ECG recording, ambulatory blood pressure monitoring, echocardiography examination, etc. According to the examinations, left ventricular geometric patterns and arrhythmias were identified. The comparison of morbidity of arrhythmias between the left ventricular remodeling group and the normal geometric pattern group was performed. The multiple stepwise regression analysis was carried out to identify the independent determinants of arrhythmias. After these predictors were controlled or adjusted, the severity of arrhythmias among different left ventricular geometric patterns was compared. It was found that the morbidity of atrial arrhythmia, ventricular arrhythmia and complex ventricular arrhythmias in the left ventricular remodeling group was significantly higher than in the normal geometric pattern group respectively. There were many independent factors influencing on arrhythmias in essential hypertension. Of all these factors, some indices of left ventricular anatomic structure, grade of hypertension, left atrial inner dimension, E/A, diastolic blood pressure load value at night and day average heart rate and so on were very important. After the above-mentioned factors were adjusted, the differences of the orders of arrhythmias between partial geometric patterns were reserved, which resulted from the differences of the geometric patterns. Many factors contributed to arrhythmias of essential hypertension, such as grade of hypertension, LVMI, LA, PWT and so on. The severity of arrhythmias was different in different left ventricular geometric patterns.