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[Correlation between ventricular arrhythmia and geometric remodeling of the left ventricle in arterial hypertension]
C Pinho1, D L Dias, M J Figueiredo
1Faculdade de Ciências Médicas da Universidade Estadual de Campinas, SP.
Insights
Patients with concentric left ventricular remodeling experience fewer ventricular arrhythmias compared to hypertrophic patterns. This geometric pattern is associated with arrhythmias closer to normal left ventricular geometry.
Area of Science:
- Cardiology
- Electrophysiology
- Hypertension Research
Background:
- Left ventricular (LV) geometry is a key determinant of cardiovascular risk.
- Ventricular arrhythmias (VAs) are a significant cause of morbidity and mortality in hypertensive patients.
- Understanding the relationship between LV geometry and VAs is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between different left ventricular geometric patterns and the presence/type of ventricular arrhythmias.
- To compare the burden of ventricular arrhythmias across distinct LV geometric patterns in patients with essential hypertension.
Main Methods:
- Seventy-two hypertensive patients were categorized into four LV geometric groups based on echocardiography: concentric remodeling, concentric hypertrophy, normal geometry, and eccentric hypertrophy.
- Ventricular arrhythmias were assessed using Holter monitoring for ventricular ectopic beats (VEB) and ventricular tachycardia (VT).
- Late potentials (LP) were evaluated using signal-averaged electrocardiogram.
Main Results:
- Patients with concentric LV remodeling (Group I) exhibited significantly fewer VEB compared to those with concentric hypertrophy (Group II) (p < 0.05).
- A trend towards fewer VEB was observed in concentric remodeling versus eccentric hypertrophy (Group IV) (p = 0.063).
- Ventricular tachycardia and late potentials were exclusively found in the hypertrophic groups (II and IV).
Conclusions:
- Concentric left ventricular remodeling is associated with a lower burden of ventricular arrhythmias compared to hypertrophic patterns.
- The arrhythmogenic profile of concentric remodeling resembles that of normal left ventricular geometry.
- LV geometry is an important factor influencing ventricular arrhythmia development in hypertension.
Purpose:
To study the presence and type of ventricular arrhythmias in patients with different geometric patterns of the left ventricle (LV).
Methods:
Seventy-two patients with essential hypertension were divided in 4 groups, by the echocardiographic patterns: group I with concentric remodeling of the LV (normal LV mass with increased relative wall thickening); group II with concentric hypertrophy (both LV mass and relative wall thickening increased); group III with normal geometry of the LV (both LV mass and relative wall thickening normal); group IV, with eccentric hypertrophy (increased LV mass with normal relative wall thickening). The groups were compared by the quantity and quality of ventricular arrhythmia, measured by the number of ventricular ectopic beats (VEB) and episodes of ventricular tachycardia (VT) on Holter monitoring, and the presence of late potentials (LP) on signal-averaged electrocardiogram.
Results:
Group I showed fewer VEB than group II (16.2 +/- 12.85 x 996.4 +/- 518.8, p < 0.05), and a statistic tendency to this result when compared with group IV (16.2 +/- 12.85 x 1634.2 +/- 1001.33, p = 0.063). When compared with group III, no statistical difference was found (16.2 +/- 12.85 x 19.8 +/- 14.81, p = NS). Episodes of VT and the presence of LP were noted only in groups II and IV.
Conclusion:
The group with concentric remodeling of the LV had fewer ventricular arrhythmias than hypertrophic groups, with characteristics closer to the patients with normal LV geometry.