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[Hypertensive cardiopathy and ventricular late potentials]
M Galinier1, J P Doazan, J P Albenque
1Service de cardiologie clinique et expérimentale, CHU Rangueil, Toulouse.
Insights
Ventricular late potentials (LP) are rare in hypertensive patients without left ventricular hypertrophy (LVH). Their incidence increases with eccentric LVH, correlating with ventricular arrhythmias in concentric LVH.
Area of Science:
- Cardiology
- Electrophysiology
- Hypertension Research
Context:
- Hypertension is a significant risk factor for cardiovascular complications.
- Left ventricular hypertrophy (LVH) is a common consequence of chronic hypertension.
- LVH is associated with an increased risk of ventricular arrhythmias.
Purpose:
- To investigate the incidence of ventricular late potentials (LP) in hypertensive patients.
- To explore the relationship between LP and ventricular arrhythmias in this population.
- To assess the impact of different types of LVH on LP and arrhythmias.
Summary:
- This study analyzed 148 hypertensive patients without coronary artery disease.
- Signal-averaged ECG, echocardiography, and Holter monitoring were used to assess LP, LVH, and arrhythmias.
- LP incidence was low in patients without LVH (5%) and with concentric LVH (13%), but high in eccentric LVH (48%).
- Arrhythmia severity correlated with LP presence in concentric LVH (p < 0.02).
Impact:
- Identifies eccentric LVH as a critical factor for LP and potential arrhythmias in hypertension.
- Highlights the diagnostic value of LP in risk stratification for hypertensive patients.
- Informs clinical management strategies for hypertensive patients at risk of ventricular arrhythmias.
Abstract:
Ventricular arrhythmias occur with increased frequency in hypertensive patients with left ventricular hypertrophy (LVH). The aim of this work is to study the incidence of ventricular late potentials (LP) and their relation to ventricular arrhythmias in 148 hypertensive patients, 87 men and 55 women, without evidence of a coronaropathy. For each patient we carried out a signal-averaged electrocardiography, an echocardiogram to determine the LV mass index (LVMI) and the LV end-diastolic dimension (EDD), and 24 hours Holter monitoring to record ventricular arrhythmias filed according to Lown's classification. LP were considered present if the root-mean-square voltage during the last 40 ms of the QRS was: < 20 uV in absence of bundle branch block, or < or = 17 uV in presence of bundle branch block. [table: see text] The frequency of LP appears exceptional in hypertensive patients without LVH (5%) and remains uncommon in patients with concentric LVH (13%). The incidence of LP is only frequent at the end stage of hypertensive cardiopathy with eccentric LVH (48%). The severity of ventricular arrhythmias is only correlated to the presence of LP in patients with concentric LVH (p < 0.02).