[Electrocardiographic and echocardiographic changes during antihypertensive therapy]

Area of Science:

• Cardiology
• Hypertension Management
• Diagnostic Imaging

Background:

• Left ventricular hypertrophy (LVH) is a common complication of hypertension.
• Assessing LVH regression during antihypertensive therapy is crucial for patient outcomes.
• Electrocardiography (ECG) and echocardiography (echo) are used to detect LVH, but their comparative effectiveness in monitoring treatment response is debated.

Purpose of the Study:

• To compare changes in ECG and echocardiographic indices of LVH during 12 months of antihypertensive therapy.
• To evaluate the sensitivity and specificity of ECG versus echo in detecting and monitoring LVH regression.
• To determine the correlation between ECG normalization and actual anatomical regression of LVH.

Main Methods:

• A prospective study of 100 hypertensive patients (mean age 46) undergoing 12 months of antihypertensive therapy.
• Baseline and follow-up assessments included ECG (Sokolow index) and echocardiography (LV mass index).
• Statistical analysis compared changes in LVH indices and assessed diagnostic performance.

Main Results:

• Pretreatment, 83% of patients had LVH by echo, and 30% by ECG; echo was more sensitive for LVH detection.
• Both LV mass index and Sokolow index decreased significantly within 3-6 months.
• After 12 months, LV mass index normalized in 19% of patients, while Sokolow index normalized in 57%, indicating faster ECG normalization but less complete regression.

Conclusions:

• ECG is less sensitive than echo for detecting LVH but shows quicker normalization during antihypertensive treatment.
• ECG normalization does not guarantee complete anatomical regression of LVH.
• Echocardiography remains essential for accurately assessing LVH regression during hypertension management.