arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2003-9-4-134-138arthyper-883Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESПоказатели гетерогенности желудочковой реполяризации в качестве диагностических критериев гипертрофии левого желудочка у пациентов с артериальной гипертензией: анализ временных показателейThe parameters of ventricular repolarization heterogeneity as diagnostic criteria for left ventricular hypertrophy in patients with arterial hypertension: analysis of temporary indicesКузнецовА. Б.KuznetsovA. B.noemail@neicon.ruГлезерМ. Г.GlezerM. G.cardiolog@inbox.ruКопыловФ. Ю.KopylovF. Yu.noemail@neicon.ruБабаахмадиС. ..BabaakhmadiS. ..noemail@neicon.ruИвановГ. Г.IvanovG. G.noemail@neicon.ruМосковская медицинская академия им. И.М. СеченоваRussian FederationГородская клиническая больница № 59; Московская медицинская академия имени И.М. СеченоваRussian Federation20032808200394134138Copyright © Кузнецов А.Б., Глезер М.Г., Копылов Ф.Ю., Бабаахмади С..., Иванов Г.Г., 20032003Кузнецов А.Б., Глезер М.Г., Копылов Ф.Ю., Бабаахмади С..., Иванов Г.Г.Kuznetsov A.B., Glezer M.G., Kopylov F.Y., Babaakhmadi S..., Ivanov G.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/883

Введение. Индексы вариабельности желудочковой реполяризации увеличены у пациентов с гипертензивной гипертрофией левого желудочка (ГЛЖ) и коррелируют с индексом массы миокарда левого желудочка (ИММЛЖ). Цель исследования. Разработка диагностических критериев ГЛЖ, основанных на анализе показателей гетерогенности желудочковой реполяризации — индексах вариабельности QT-, JT- и Тapex-T-end-интервалов. Материалы и методы. В исследование включены 69 пациентов с артериальной гипертензией и 20 пациентов без заболеваний сердечно-сосудистой системы, которые на основании эхокардиографического определения ИММЛЖ были разделены на группы с наличием и отсутствием ГЛЖ. Проанализированы следующие индексы вариабельности реполяризационных показателей: дисперсия (Дисп), нормализованная дисперсия (Диспнорм) и среднеквадратическое отклонение (СКО) QTend-, JTend-, QTapex-, JТapex- и Tapex-Tend-интервалов ЭКГ-12. Результаты. У мужчин с ГЛЖ в сравнении с пациентами с нормальным ИММЛЖ были увеличены показатели вариабельности QТend-интервалов, JТend-интервалов и Tapex-Tend-интервалов, которые коррелировали с ИММЛЖ. При регрессионном анализе ИММЛЖ был независимым предиктором показателей вариабельности QТend-интервалов и JТend-интервалов. Лучшие диагностические характеристики продемонстрировали Дисп JТend-интервалов ≥ 71 мс и Диспнорм JТend-интервалов ≥ 22 мс (чувствительность 52 %, специфичность 91 %, положительная предсказательная значимость 89 %, отрицательная предсказательная значимость 57 %). У женщин с ГЛЖ в сравнении с пациентами с нормальными ИММЛЖ были увеличены показатели вариабельности Tapex-Tend-интервалов, которые коррелировали с ИММЛЖ. При регрессионном анализе ИММЛЖ был независимым предиктором показателей вариабельности Tapex-Tend-интервалов. Лучшие диагностические характеристики продемонстрировала Дисп Tapex-Tend-интервалов ≥ 61 мс (чувствительность 45 %, специфичность 93 %, положительная предсказательная значимость 91 %, отрицательная предсказательная значимость 52 %). Выводы. Показатели гетерогенности желудочковой реполяризации могут применяться в качестве самостоятельных критериев ГЛЖ у пациентов с АГ.

Introduction. The indices of ventricular repolarization variability arc higher in patients with hypertensive left ventricular hypertrophy (LVH) and correlate with the Left ventricular myocardial mass index (LVMMI). Aim. To develop diagnostic criteria for I.VI I, based on the analysis of the parameters of ventricular repolarization heterogeneity - the variability indices QT-, JT- и Тapex-T-end-intervals. Subjects and methods. The study enrolled 69 patients with arterial hypertension and 20 patients without cardiovascular diseases who were divided on the basis of echocardiographic determination of LVMMI into those with and without LVH. The following repolarization variability indices: dispersion (Disp), normalized dispersion (Dispnorm), and standard deviation (SD) QTend-, JTend-, QTapex-, JТapex- и Tapex-Tend-intervals of EGG lead 12, were analyzed. Results. As compared with male patients with normal LVMMI, the male patients with LVH had higher parameters of variability of QТend-intervals, JТend-intervals и Tapex-Tend-intervals, which correlated with l.VMMI. During a regression analysis, LVMMI was an independent predictor of the indices of variability of QТend-intervals и JТend-intervals. Disp of JТend-intervals ≥ 71 msec and Dispnorm JТend-intervals ≥ 22 msec (52 % sensitivity, 91 % specificity, 89 % positive prognostic value, 57 % negative prognostic value). As compared with female patients with normal LVMMI, the female patients with LVH had higher parameters of variability Tapex-Tend-intervals, which correlated with LVMMI. During a regression analysis, LVMMI was an independent predictor of the indices of variability of Tapex-Tcnd-intervals. Disp of Tapex-Tend-intervals of ≥ 61 msec demonstrated the best diagnostic characteristics (45 % sensitivity, 94 % specificity, 91 % positive prognostic value, 52 % negative prognostic value). Conclusions. The parameters of ventricular repolarization heterogeneity may be used as independent criteria for LVH in patients with arterial hypertension.

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The authors declare that there are no conflicts of interest present.