Related Experiment Videos
Risk of ventricular arrhythmias in hypertensive men with left ventricular hypertrophy
D Siegel1, M D Cheitlin, D M Black
1Department of Epidemiology and Biostatistics, University of California, San Francisco.
Insights
Left ventricular hypertrophy identified by echocardiography predicts ventricular arrhythmias in men with hypertension. This finding was consistent before and after electrolyte repletion, highlighting its clinical significance.
Area of Science:
- Cardiology
- Clinical Electrophysiology
- Cardiac Imaging
Background:
- Left ventricular hypertrophy (LVH) is a known risk factor for cardiovascular events.
- The relationship between echocardiographic LVH and ventricular arrhythmias in hypertensive individuals requires further elucidation.
Purpose of the Study:
- To investigate echocardiographic predictors of ventricular arrhythmias in men with mild hypertension.
- To assess the association between left ventricular hypertrophy (LVH) and the occurrence of ventricular arrhythmias.
Main Methods:
- M-mode echocardiography and 24-hour ambulatory electrocardiography were performed on 123 men with mild hypertension.
- Participants underwent electrolyte repletion with potassium and magnesium for one month.
- Left ventricular mass index was used to define echocardiographic LVH.
Main Results:
- Thirty-nine percent of men exhibited echocardiographic LVH (LV mass index > 134 g/m2).
- Echocardiographic LVH was associated with a higher likelihood of frequent ventricular premature complexes (VPCs)/hr, multiform extrasystoles, and ventricular tachycardia.
- Similar associations were observed before electrolyte repletion.
Conclusions:
- Echocardiographic evidence of left ventricular hypertrophy is a significant predictor of ventricular arrhythmias in hypertensive men.
- These findings underscore the importance of cardiac imaging in risk stratification for arrhythmias.
Abstract:
The echocardiographic predictors of ventricular arrhythmias are reported for the Hypertension Arrhythmia Reduction Trial. Men with mild hypertension were withdrawn from their diuretic therapy and repleted with 40 mEq/day of oral potassium and 20 mEq/day of oral magnesium for 1 month. M-mode echocardiography and 24-hour continuous ambulatory electrocardiography were performed on 123 men, mean age 62 years. Forty-eight men (39%) had echocardiographic evidence of left ventricular (LV) hypertrophy defined as an LV mass index greater than 134 g/m2 and this finding was not related to the presence of LV hypertrophy on electrocardiogram or to age. Men who had echocardiographic LV hypertrophy were more likely than men without echocardiographic LV hypertrophy to have greater than or equal to 30 ventricular premature complexes (VPCs)/hr (odds ratio = 2.7; 95% confidence interval = 0.9, 8.0), multiform extrasystoles (odds ratio = 1.7; confidence interval = 0.8, 3.7), episodes of ventricular tachycardia (odds ratio = 2.3; confidence interval = 0.7, 7.1) and the combination of frequent (greater than or equal to 30 VPCs/hr) or complex (ventricular couplets, multiform extrasystoles or episodes of ventricular tachycardia) ventricular arrhythmia (odds ratio = 1.7; confidence interval = 0.8, 3.5). Similar associations between echocardiographic LV hypertrophy and ventricular arrhythmias were observed on 24-hour tracings obtained on entry to the study (before electrolyte repletion) in the 96 men who were taking diuretics at this time. The combination of a frequent or complex arrhythmia was also more common in men aged 60 to 70 compared to men aged 35 to 59 (odds ratio = 3.4; confidence interval = 1.4, 8.2).(ABSTRACT TRUNCATED AT 250 WORDS)