QT dispersion in patients with hypertensive disease

Abstract

QТ dispersion was studied in 60 patients (12 males and 38 patients; their mean age, 48,4 ± 9,1) with Grades I — III arterial hypertension. Patients with prior myocardial infarction, with angina pectoris, and with severe heart failure were excluded. The hypertrophy of the myocardium, its systolic and diastolic function were evaluated with echocardiography. QT dispersion was determined by ECG. In arterial hypertension, the myocardium was found to be characterized by the development of not only hypertrophy of the left ventricle (LV), but also by its remodelling. Multifactorial regression analysis indicated that systolic blood pressure had an independent direct impact on the relative thickness of the LV wall and on LV mass index. There was a direct correlation of trans-myocardial QT dispersion with the parameters of pulmonary venous blood flow, reflecting the early symptoms of heart failure: Smax, the peak velocity of systolic flow; S/D, the ratio of the peak velocities of systolic and diastolic flows; VTIAR/Va, the ratio of the integral parameter of reversion flow to the time-velocity integral of peak A of transmitral blood flow. It is concluded that in patients with arterial hypertension, transmyocardial QT dispersion increases with the occurrence of the early symptoms of heart failure, as evidenced by transmittal and pulmonary venous flows.