QTc dispersion and Cornell duration product can predict 10-year outcomes in hypertensive patients with left
Dragan B Djordjević1,2, Ivan S Tasić1,2, Svetlana I Kostić2
1Medical Faculty, Department of Internal Medicine, University of Niš, Niš, Serbia.
Insights
In patients with hypertension and left ventricular hypertrophy (LVH), a positive Cornell product and increased QTc dispersion predict worse 10-year outcomes. These non-invasive markers aid in identifying high-risk individuals for improved management.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Prediction
Background:
- Persistent and adequate treatment of arterial hypertension is crucial for better patient outcomes.
- Left ventricular hypertrophy (LVH) is a known complication of hypertension.
- Additional non-invasive predictors of prognosis in hypertensive patients with LVH require identification.
Purpose of the Study:
- To identify non-invasive predictors of unfavorable prognosis in patients with essential arterial hypertension and LVH.
- To evaluate the 10-year outcome in a cohort of hypertensive patients with LVH.
- To assess the prognostic significance of the Cornell product and QTc dispersion.
Main Methods:
- A cohort of 124 hypertensive patients with LVH was studied noninvasively.
- Patients received regular medication therapy throughout the 10-year follow-up period.
- Baseline parameters including left ventricular mass index, QTc dispersion, Cornell product, and Lyon-Sokolow score were assessed.
Main Results:
- Unfavorable outcomes occurred in 32.3% of patients over 10 years.
- Patients with unfavorable outcomes had higher baseline left ventricular mass index and QTc dispersion.
- A positive Cornell product was more frequent in patients with unfavorable outcomes (35% vs. 22.2%).
Conclusions:
- The Cornell product and QTc dispersion are significant predictors of unfavorable 10-year outcomes in hypertensive patients with LVH.
- Elevated QTc dispersion (>65 ms) and a positive Cornell product identify patients at higher risk.
- These non-invasive parameters can aid in risk stratification and management of hypertensive patients with LVH.
Background:
Persistent and adequate treatment of patients with arterial hypertension leads to more favorable disease outcome.
Hypothesis:
Aside for the present left ventricular hypertrophy (LVH), there are other non-invasive parameters which can represent additional predictors of unfavorable prognosis in patients with essential arterial hypertension during the 10-year follow-up.
Methods:
A hypertensive group with LVH (124 patients; age 57.0 ± 8.0; 84 males and 40 females) was included in the study and examined noninvasively. Patients used regular medication therapy during the follow-up period.
Results:
During the 10-year follow-up period, unfavorable outcome was recorded for 40 (32.3%) patients. Patients with unfavorable outcome had higher baseline values of left ventricular mass index (178.9 ± 29.5 g/m2 vs 165.5 ± 29.5 g/m2 ; P < 0.05) and QTc dispersion (64.1 ± 24.7 ms vs 54.8 ± 19.4 ms; P < 0.05). Frequency of positive Cornell product was higher in the group of patients with unfavorable outcome (35% vs 22.2%; P < 0.01). Positive Lyon-Sokolow score did not show statistical significance (25% vs 11.9%; P = 0.06). Cornell product (β = 0.234; P < 0.01) and QTc dispersion >65 ms (β = 0.184; P < 0.05) had prognostic significance in LVH (multiple regression analysis: R = 0.314, R = 0.099, adjusted R = 0.084, standard error of the estimate = 0.449, P < 0.05).
Conclusions:
Patients with a positive Cornell product and larger QTc dispersion had more unfavorable 10-year outcomes compared with other patients with LVH.
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