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Relation between age, left ventricular mass and ventricular arrhythmias in patients with hypertension
N Ferrara1, G Furgi, G Longobardi
1Clinica del Lavoro Foundation, Institute of Care and Research, Campoli del Monte Taburno (BN), Italy.
Insights
Age does not influence ventricular arrhythmias in hypertensive patients. Left ventricular hypertrophy is the primary factor driving these arrhythmias, independent of patient age.
Area of Science:
- Cardiology
- Hypertension Research
- Arrhythmia Studies
Background:
- Essential arterial hypertension is a significant risk factor for cardiovascular complications.
- Left ventricular hypertrophy (LVH) is a known consequence of hypertension and is associated with increased arrhythmia risk.
- The specific role of age in the relationship between LVH and arrhythmias in hypertensive patients requires further elucidation.
Purpose of the Study:
- To investigate the independent effect of age on left ventricular hypertrophy-related arrhythmias in patients with essential arterial hypertension.
- To determine whether age or left ventricular hypertrophy is a stronger predictor of ventricular arrhythmias in this population.
Main Methods:
- A cohort of 68 hypertensive patients without other cardiovascular disorders was studied.
- M-mode and two-dimensional echocardiography were performed to assess left ventricular structure and mass.
- 24-hour ambulatory electrocardiographic monitoring was utilized to evaluate premature ventricular beats and arrhythmia severity (modified Lown grade).
Main Results:
- Premature ventricular beats (PVB) and modified Lown grade showed a significant positive correlation with left ventricular mass index (LVMI).
- No significant relationship was found between age and the number or severity of PVBs.
- Arrhythmia parameters were not significantly related to left ventricular internal dimension, fractional shortening, or blood pressure levels.
Conclusions:
- Left ventricular hypertrophy, not chronological age, is a significant determinant of ventricular arrhythmias in hypertensive individuals.
- The mechanism linking LVH to arrhythmias in hypertension differs from age-related mechanisms of arrhythmia development.
- These findings highlight LVH as a critical therapeutic target for reducing arrhythmia risk in hypertension.
Abstract:
To evaluate the effect of age on left ventricular hypertrophy-related arrhythmias in patients with essential arterial hypertension, 68 hypertensives (47 men and 21 women, mean age 59.4 +/- 9.5 years) without other cardiovascular disorders were studied. All patients underwent M-mode and two-dimensional echocardiogram and 24 h ambulatory electrocardiographic monitoring to measure left ventricular internal dimension, septum and posterior wall thickness, left ventricular mass index, premature ventricular beats and modified Lown grade. Premature ventricular beats (PVB) and modified Lown grade were significantly related to left ventricular mass index, but not to left ventricular internal dimension, fractional shortening, systolic and diastolic blood pressure. There was no relation between age and number of PVB, or severity of arrhythmias. In conclusion, in hypertensive patients only left ventricular hypertrophy, and not age, plays a significant role in the pathophysiology of the increased incidence of ventricular arrhythmias by a different mechanism than age-related increased ventricular arrhythmias.