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[Delayed potentials and left ventricular hypertrophy]
F Tremel1, C Schwebel, P Longère
1Service de médecine interne et cardiologie, CHRU, Grenoble.
Insights
Delayed potentials (DP) are linked to heart rhythm issues. This study found no significant link between DP and left ventricular hypertrophy (LVH) in hypertensive patients, suggesting other factors influence DP prevalence.
Area of Science:
- Cardiology
- Electrophysiology
- Hypertension Research
Background:
- Delayed potentials (DP) are established markers for ventricular rhythm disturbances and carry prognostic value post-myocardial infarction.
- The prevalence of DP in hypertensive heart disease varies widely (1-40%), and their prognostic significance remains unclear.
- Left ventricular hypertrophy (LVH) is a common consequence of hypertension, potentially influencing cardiac electrical activity.
Purpose of the Study:
- To investigate the frequency of DP in patients with essential hypertension (HT).
- To examine the relationship between DP and left ventricular hypertrophy (LVH) assessed by echocardiographic LV mass index (LVMI).
- To explore potential correlations between DP and other clinical variables in hypertensive patients.
Main Methods:
- Fifty consecutive patients with essential HT were studied, excluding those with coronary artery disease, bundle branch block, or poor echocardiographic traces.
- ECG-Holter analysis (ECGHA) was performed using an ART device to detect DP based on Kacet criteria.
- Left ventricular mass index (LVMI) was determined using the Penn method, with LVH defined by Devereux criteria; other variables included age, sex, HT duration, micro-albuminuria, and ECG-based LVH.
Main Results:
- No significant correlations were found between the presence of DP and studied variables, including LVMI, age, sex, HT duration, micro-albuminuria, or ECG-defined LVH.
- The prevalence of DP did not significantly differ between patients with and without LVH on echocardiography (35% vs. 25%; p = 0.53).
- While not statistically significant, 3 out of 10 patients with the highest LVMI exhibited DP.
Conclusions:
- This study found no significant association between delayed potentials (DP) and left ventricular hypertrophy (LVH) in patients with essential hypertension.
- The findings suggest that electrophysiologic, ischemic, or histological factors, rather than LVH, may better explain the occurrence of DP in hypertensive heart disease.
- Further research is needed to elucidate the precise mechanisms and prognostic implications of DP in the context of hypertension.
Abstract:
Delayed potentials (DP) (ECGHA) are markers of the occurrence of ventricular rhythm disturbances, and have a prognostic value after myocardial infarction. In hypertensive heart disease, the prevalence of DP is variable according to the literature (1-40%) and their prognostic significance is not known. We examine the frequency of DP in hypertension (HT) and the relationship between DP and left ventricular hypertrophy (LVH) as defined by echocardiographic estimation of the LV mass index (LVMI). We investigated 50 consecutive patients with essential HT who were being assessed as regards cause and effects of HT. Exclusion criteria were coronary artery disease, bundle branch block and poor echocardiographic trace. ECGHA was registered by means of ART device. The presence of DP as defined according to the criteria of Kacet. LV mass was determine according to the method of Penn and LVH defined according to the criteria of Devereux. Besides LVMI, were examined age, sex, duration of HT, micro-albuminuria, LVH on ECG (Sokolow index and strain-ECG). There were no correlations between the different variables studied and the presence of DP. The results relating to LVMI are shown in Table. There were no correlation between DP and LVH on echography. Other explanations, electrophysiologic, ischemic and histological may explain the greater incidence of BP observed in hypertensive heart disease. [table: see text] The prevalence of DP was not significantly different as regard the presence or absence of LVH (35% vs 25%; p = 0.53). In the 10 patients with the highest LVMI, the DP were enregistered 3 times.