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[Relationship between ventricular arrhythmia and clinical and echocardiographic parameters in hypertensive patients]
E Pedro1, M Falcão, D Bonhorst
1Serviço de Cardiologia do Hospital de Santa Cruz.
Objective:
Evaluation in arterial hypertension (HTA) patients, of the relationship between supraventricular and ventricular arrhythmias, stage of hypertension and echocardiographic parameters.
Design:
Retrospective study based on the files of ambulatory electrocardiography (Holter).
Setting:
Arrhythmology Outpatients Clinic from a Cardiac Department.
Patients:
Adult patients with arterial hypertension, males and females, who underwent ambulatory electrocardiography (Holter) and echocardiography examinations.
Material And Methods:
Thirty patients, 15 males and females, 54 +/- 12 years old, were studied. Arterial hypertension was stratified in three stages according with the diastolic value. Symptoms, serum potassium, left ventricular hypertrophy (LVH) on the ECG, and echocardiographic parameters such as left ventricular dimensions, shortening fraction, septal wall and posterior wall thickness and left atrium dimensions were analysed. These parameters were correlated with the arrhythmic pattern concerning the number of premature supraventricular contractions and the number and complexity of premature ventricular contractions (PVC), evaluated by ambulatory electrocardiography (Holter).
Results:
No relation was found between the arrhythmic pattern, stage of hypertension, symptoms and LVH on the ECG. Septal wall thickness was 14 +/- 3 mm in the group of patients with PVC greater than or equal to 10/hour and 12 +/- 3 mm in the population with PVC less than 10/hour (p less than 0.04). The shortening fraction was 27 +/- 8% in the group of repetitive PVC and 34 +/- 7% in the population without (p less than 0.003). A borderline relation was found between repetitive PVC and left atrium and left ventricular diastolic dimensions.
Conclusions:
In a population of arterial hypertension (HTA) who performed ambulatory electrocardiography (Holter), the prevalence of frequent or repetitive PVC was low. A positive correlation between frequent PVC and septal wall thickness and an inverse relation between repetitive PVC and LV shortening fraction, was found. These conclusions are according with the literature, relating the ectopic activity with LVH or deterioration of LV function. No relation was found between arrhythmias and stage of hypertension.