The parameters of ventricular repolarization heterogeneity as diagnostic criteria for left ventricular hypertrophy in patients with arterial hypertension: analysis of temporary indices

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 Т_apex-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) QT_end-, JT_end-, QT_apex-, JТ_apex- и T_apex-T_end-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 QТ_end-intervals, JТ_end-intervals и T_apex-T_end-intervals, which correlated with l.VMMI. During a regression analysis, LVMMI was an independent predictor of the indices of variability of QТ_end-intervals и JТ_end-intervals. Disp of JТ_end-intervals ≥ 71 msec and Dispnorm JТ_end-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 T_apex-T_end-intervals, which correlated with LVMMI. During a regression analysis, LVMMI was an independent predictor of the indices of variability of T_apex-T_cnd-intervals. Disp of T_apex-T_end-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.

left ventricular hypertrophy, ventricular repolarization variability index

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