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Ventricular activation time as a marker for diastolic dysfunction in early hypertension

Usama Boles1, Ibrahim Almuntaser, Angie Brown

  • 1Department of Therapeutics, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland. bolesu@tcd.ie

American Journal of Hypertension
|March 27, 2010
PubMed

Insights

Ventricular activation time (VAT) is a potential early marker for diastolic dysfunction (DD) in hypertension. Prolonged VAT on ECG correlates with echocardiographic findings of DD in newly diagnosed hypertensive patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Markers

Background:

  • Standard electrocardiogram (ECG) in hypertensive patients primarily detects left ventricular hypertrophy.
  • Diastolic dysfunction (DD) in hypertension is often identified earlier via echocardiography than increased left ventricular mass.
  • ECG markers for early diastolic dysfunction (DD) in hypertension are not well-defined.

Purpose of the Study:

  • To assess ventricular activation time (VAT) as a potential ECG marker for early diastolic dysfunction (DD) in newly diagnosed, untreated hypertension.
  • To investigate the correlation between ECG-derived VAT and echocardiographic parameters of left ventricular diastolic function.

Main Methods:

  • Ninety newly diagnosed, untreated hypertensive subjects underwent 12-lead ECG and comprehensive echocardiography.
  • Left ventricular diastolic function was assessed using Canadian Consensus Guidelines and tissue Doppler imaging (TDI).
  • Ventricular activation time (VAT), corresponding to the QR interval on ECG, was compared with echocardiographic DD parameters.

Main Results:

  • Ventricular activation time (VAT) was significantly prolonged in subjects with diastolic dysfunction (DD) (46.3 ms vs. 39.6 ms, P < 0.01).
  • VAT showed significant correlations with TDI parameters (e', e'/a'), transmitral Doppler (TMD) parameters (E/A), and the E/e' ratio.
  • Specific correlations included VAT with e' (r = -0.53), e'/a' (r = -0.53), E/A (r = -0.32), and E/e' (r = 0.44), all with P < 0.001.

Conclusions:

  • Prolongation of ventricular activation time (VAT) is associated with diastolic dysfunction (DD) in hypertensive patients.
  • VAT may serve as a valuable, non-invasive ECG marker for detecting early diastolic dysfunction in hypertension.
  • Further research can explore VAT's utility in managing hypertensive cardiovascular complications.
Abstract

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