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Predictive value of non-invasive parameters in patients with left ventricular hypertrophy during a five-year
Dragan Djordjević1, Ivan Tasić, Bojana Stamenković
1School of Medicine, University of Nis, Nis, Serbia. nikaca@sbb.rs
Insights
Left ventricular hypertrophy increases cardiovascular risk. Key predictors of poor outcomes in hypertensive patients include QTc interval dispersion, septal wall thickness, and heart rate response to exercise.
Area of Science:
- Cardiology
- Hypertension Research
- Predictive Medicine
Background:
- Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular complications, independent of other factors.
- Accurate prediction of patient outcomes at the start of treatment is crucial in clinical practice.
Purpose of the Study:
- To evaluate the five-year predictive value of non-invasive parameters in patients with essential arterial hypertension and LVH receiving regular therapy.
- To identify early indicators of adverse cardiovascular events.
Main Methods:
- Ninety hypertensive patients with LVH (average age 55) were studied at baseline after discontinuing prior antihypertensive therapy.
- A five-year follow-up period was conducted to monitor adverse cardiovascular events.
- Stepwise multiple regression analysis was used to identify predictive parameters.
Main Results:
- QTc interval dispersion (beta = 0.325, p = 0.001), septal wall thickness (beta = 0.294, p = 0.003), and a low increase in heart rate during exercise testing (beta = -0.202, p < 0.04) were significant predictors.
- The predictive model (adjusted R square = 0.203, p < 0.0001) identified these parameters.
Conclusions:
- Patients with greater QTc dispersion, increased septum thickness, and diminished heart rate increase during exercise face worse outcomes despite regular treatment.
- These findings suggest a need for early identification and more aggressive treatment strategies for high-risk patients.
Introduction:
Regardless of other known factors, left ventricular hypertrophy is considered to be a significant factor which correlates with the risk of cardiovascular complications. In practice, it is very important to predict the outcome for every patient at the beginning of the treatment.
Objective:
The aim of the study was to follow the predictive value of non-invasive parameters obtained at the beginning of the study in patients with essential arterial hypertension and left ventricular hypertrophy who were treated by regular therapy through a five year follow-up period.
Methods:
Ninety patients (average age 55) with essential hypertension and left ventricular hypertrophy were examined. All patients were studied at baseline after temporary discontinuation of previous antihypertensive therapy. The follow-up period started at the baseline examination and lasted for five years. Adverse cardiovascular events occurred in 15 (16.7%) patients.
Results:
Non-invasive parameters were tested by stepwise multiple regression analysis. Three examined parameters had predictive value: QTc interval dispersion (beta = 0.325, p = 0.001), septal wall thickness (beta = 0.294, p = 0.003) and low increase of the heart rate during exercise testing (beta = -0.202, p < 0.04). For this model, adjusted R square = 0.203; F3,84 = 8.406, p < 0.0001.
Conclusion:
In spite of regular medical treatment, patients with larger QTc dispersion, greater septum thickness and lower increase of heart rate during exercise testing showed worse outcome through the follow-up period. These patients should be recognized as early as possible and treated more aggressively.
