Prognostic value of delayed and non-homogeneous ventricular repolarization and decreased variability of cardiac rhythm in males with arterial hypertension (clinical population study)

The increased duration and dispersion of the QT-interval and the depressed variability of cardiac rhythm have been recently considered to be predictors of life-threatening ventricular arrhythmias and sudden death. However. the prognostic value of these indices in patients with arterial hypertension (AH) is little studied. Three representative samples from the total population of 2167 males aged 25-64 years were examined by conventional epidemiological methods within the framework of the WHO "MONICA" project. In a group of patients with AH (n = 415), fatal cardiovascular events were studied for 9,5 years. Resting ECG was blindly evaluated according lo the Minnesota code and the duration of the QT and QTc intervals, their dispersion were manually determined on the basis of 12 standard leads (DQT and DQTc), heart rate, and its variability (SDNN). The prognostic value of threshold indices (QTc ≥ 440 msec_1/2 DQT ≥ 60 msec, DQTc ≥ 60 msec_1/2 and SDNN ≤ 20 msec) was studied by the survival methods: the Cox model, the Log-rant-test, and the Kaplan-Meier curves. In the total male population. AH is associated with the relative increase in the duration and dispersion of QT interval, with accelerated sinus rhythm, and its decreased variability. In the group of males with AH, these electrophysiological changes identify individuals at high risk for cardiovascular death irrespective of age, body mass index, blood pressure, smoking, alcohol abuse, blood lipid levels, the presence of coronary heart disease and left ventricular hypertension.

total male population, cardiovascular death, QT-interval, QT-interval dispersion, heart rate variability

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