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[Quantitative repolarization indices in diagnosis of left ventricular hypertrophy in hypertensive patients]
Insights
Quantitative ECG repolarization parameters significantly improve diagnosis of left ventricular hypertrophy (LVH) in hypertensive patients. These novel electrocardiogram (ECG) metrics offer enhanced diagnostic accuracy for this common cardiovascular condition.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Context:
- Hypertension is a leading cause of left ventricular hypertrophy (LVH).
- Early and accurate diagnosis of LVH is crucial for managing hypertensive patients.
- Current diagnostic methods for LVH have limitations.
Purpose:
- To evaluate the diagnostic value of quantitative electrocardiogram (ECG) repolarization parameters in hypertensive patients with LVH.
- To identify the most informative ECG parameters for LVH detection.
Summary:
- This study analyzed quantitative ECG repolarization parameters in 241 hypertensive patients with LVH and 210 controls.
- Specific components of the T wave integral and maximal vectors, along with the phi angle, were found to be highly informative.
- A discriminant function incorporating key depolarization and repolarization indices demonstrated superior diagnostic performance compared to individual variables.
Impact:
- The findings suggest that quantitative repolarization analysis can enhance the diagnosis of LVH in hypertensive individuals.
- This approach may lead to improved patient management and outcomes.
- Further validation in larger cohorts is warranted.
Aim:
To determine informative value of quantitative parameters of orthogonal ECG repolarization phase in diagnosis of left ventricular hypertrophy (LVH) in hypertensive patients.
Material And Methods:
A total of 210 healthy subjects and 241 hypertensive patients with LVH (LV myocardium mass index > 125 g/m2 in males and > 110 g/m2 in women) comprised two groups--control and test. The study was made of quantitative parameters (components X, Y, Z, modules and angles of azimuth and elevation) of wave T integral vector, wave T maximal vector, ST vector, ventricular gradient; spatial and projection areas of wave T, the angle between integral vectors of spatial waves QRS and T (phi angle).
Results:
The test group had reduced X, Y components and elevated vectors, their azimuth and phi angle. Most informative for repolarization were components X of T maximal and integral vectors being as informative as Rx+Sz and Cornel product. The method of multiple regression analysis was used to plot discriminant function taking account of most informative indices of depolarization and repolarization--Rx+Sz and X component of T maximal vector. The area under ROC curve for this function was greater than for the variables alone and Cornel product in both groups (0.90 +/- 0.02 and 0.86 +/- 0.02, p < 0.05 for the control and test group, respectively).
Conclusion:
Quantitative parameters of repolarization phase can improve LVG diagnosis in hypertensive patients.
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