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

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.