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[Vector-echocardiographic correlations in left ventricular hypertrophy of arterial hypertension]
1Groupe Médical des Trois Fontaines, Cergy-Pontoise.
Insights
Hypertension-induced left ventricular hypertrophy (LVH) shows specific electrocardiography and echocardiography markers. Correlations between spatial vectors and LVH mass/wall thickness are significant, though conduction disorders may alter them.
Area of Science:
- Cardiology
- Medical Imaging
- Biophysics
Background:
- Left ventricular hypertrophy (LVH) is a common consequence of hypertension (HT).
- Understanding the relationship between electrocardiographic (ECG) and echocardiographic (Echo) findings in hypertensive LVH is crucial for diagnosis and management.
- Conduction disorders can complicate the interpretation of cardiac imaging and electrical activity.
Purpose of the Study:
- To correlate segmental and spatial vectorial ECG/vectocardiographic (VCG) parameters with segmental echocardiographic and mass parameters in hypertensive LVH.
- To identify significant quantitative variables in hypertensive LVH.
- To investigate the impact of conduction disorders on these correlations.
Main Methods:
- Correlation analysis of ECG/VCG parameters (e.g., QRS vectors, ventricular gradient) with echocardiographic parameters (e.g., septal and posterior wall thickness, left ventricular mass index).
- Study included nearly 200 cases of hypertensive LVH, with subgroups of normal adults and children, and cases with conduction disorders.
- Statistical analysis to determine significant variables and correlations (p < 0.05).
Main Results:
- Significant quantitative ECG/VCG variables in hypertensive LVH include spatial vector magnitude, azimuth, elevation, maximal posterior/anterior vector amplitudes, QRS width, and ventricular gradient.
- Significant echocardiographic variables include left ventricular mass index, septal and posterior wall thickness, and VMNES.
- Significant correlations were found between the maximal posterior QRS vector and posterior wall thickness (0.01 < alpha < 0.02), and spatial vector and LV mass index (0.01 < alpha < 0.001).
Conclusions:
- Specific ECG/VCG and echocardiographic parameters are significantly associated with hypertensive LVH.
- The spatial vector magnitude and posterior QRS vector amplitude show significant correlations with LV mass index and posterior wall thickness, respectively.
- Conduction disorders do not alter the qualitative nature of these key variables but do affect the strength of their correlation.
Abstract:
In almost 200 case of left ventricular hypertrophy (LVH) secondary to hypertension (HT), including 75 cases with conduction disorders, 100 cases of normal adults and 20 cases of normal children, segmental (initial horizontal vector, maximal anterior and posterior vector of the QRS) and spatial vectorial parameters were correlated to segmental echocardiographic parameters (septum, anterior and posterior wall of the left ventricle) and mass parameters (left ventricular mass index). The only significant quantitative variables in hypertensive LVH are: on electrocardiography: the AQRS and Sokolow's index: on vectocardiography: the spatial vector: its magnitude, azimuth and elevation, the maximal posterior vector: its amplitude, the maximal anterior vector: its amplitude, the maximal width of the QRS azimuth of the efferent limb of the QRS, the ventricular gradient in the horizontal, frontal and sagittal planes; on echocardiography: the left ventricular mass index, the diastolic thickness of the septum and the VMNES, the diastolic thickness of the posterior wall of the left ventricle and its percentage thickening. The only significant correlations were observed between: the maximal posterior vector of QRS and the diastolic thickness of the posterior wall of the left ventricle: 0.01 < alpha < 0.02; the spatial vector and the left ventricular mass index: 0.01 < alpha < 0.001. The presence of a conduction disorder does not modify these last two qualitative variables but alters their correlation.