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Prolonged recovery time in the left precordial leads reflects increased left ventricular mass in the hypertensive

Hideyuki Hara1, Shinichi Niwano, Noriaki Ikeda

  • 1Department of Internal Medicine/Cardiology, School of Medicine, Kitasato University, Kanagawa 228-8555, Japan. hideyuki@med.kitasato-u.ac.jp

Journal of Electrocardiology
|October 12, 2005
PubMed

Insights

Hypertensive left ventricular hypertrophy (LVH) increases T-wave changes, indicating repolarization abnormalities. Increased left ventricular mass correlates with greater dispersion in activation recovery interval and recovery time, suggesting arrhythmogenicity risk.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Hypertensive left ventricular hypertrophy (LVH) is linked to arrhythmogenicity.
  • Quantifying T-wave morphology changes, reflecting repolarization abnormalities, requires further investigation.

Purpose of the Study:

  • To quantify T-wave changes in hypertensive patients.
  • To investigate the relationship between T-wave changes and increased left ventricular mass.

Main Methods:

  • Standard 12-lead ECG and echocardiography in 90 hypertensive patients.
  • Measurement of activation time (AT), activation recovery interval (ARI), and recovery time (RT) in precordial leads.
  • Calculation of parameter dispersion and correlation with left ventricular mass index (LVMI).

Main Results:

  • LVH group showed significantly greater dispersion of ARI and RT compared to non-LVH group.
  • Left ventricular mass index correlated significantly with dispersion of RT (r=0.66), ARI (r=0.61), and 12-lead QT (r=0.42).
  • Significant prolongation of RT in left precordial leads was observed in LVH patients.

Conclusions:

  • Increased dispersion of ARI and RT in hypertensive patients with LVH suggests nonuniformity of epicardial action potential duration.
  • These repolarization abnormalities may contribute to the arrhythmogenic risk associated with hypertensive LVH.

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