The Relationship Between the Index of Cardio-Electrophysiological Balance and the Non-Dipper Hypertensive Pattern in
Seda Tükenmez Karakurt1, Hüseyin Karakurt1, Nail Güven Serbest1
1Department of Cardiology, M.D. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training Research Hospital, Istanbul, Turkey.
Abstract:
The connection between different electrocardiography (ECG) parameters and circadian blood pressure (BP) variations in patients with hypertension (HT) has been investigated. The index of cardio-electrophysiological balance (iCEB), determined as the quotient of the QT interval and the QRS duration, offers an assessment of the comprehensive equilibrium between depolarization and repolarization. This study aimed to explore the relationship between iCEB and circadian BP variability. After applying exclusion criteria, a total of 144 individuals were diagnosed with HT based on the 24 h ambulatory blood pressure monitoring (ABPM) results. Using the results from 24 h ABPM, the study participants were divided into two groups: those with dipper HT and those with non-dipper HT. The iCEB is calculated by dividing the QT interval by the QRS duration (QT/QRS). The iCEB was significantly higher in individuals with non-dipper HT compared to those with dipper HT. (3.88 ± 0.6 vs. 4.38 ± 0.89 respectively, p < 0.001). Univariate logistic regression analysis revealed significant correlations between non-dipper hypertensive pattern and creatinine, frontal QRS-T angle (FQRSTA), and iCEB. As a result of multivariate analysis, iCEB (OR:3.125, 95% CI: 1.595-6.117; p = 0.001) was found to be an independent predictor of non-dipper HT. iCEB optimal cut-off value of > 4.1 predicted non-dipper hypertensive pattern with 67.4% sensitivity and 67.3% specificity. This study indicated that a higher iCEB was linked to non-dipper HT in newly diagnosed hypertensive patients.
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