Abstract
Objective: To evaluate the 24-hour Holter ECG recording in hypertensive heart disease. Methods: This was a descriptive and analytical cross-sectional study on files of patients with hypertensive heart disease, carried out from October 2016 to October 2019, in two health facilities in Lome (TOGO). Electrical left ventricular hypertrophy (LVH) was defined by the Sokolow-Lyon and Cornell indices. On echocardiography, the HVG according to the criteria of the American Society of Echocardiography, was the characteristic retained for a CH. Holter-ECG recordings were carried out over 24 hours by two Holter devices. Results: 107 patients were included, with a sex ratio of 1.89 (M / F). The mean age was 62.2 ± 12 years. The mean duration of the evolution of hypertension was 10.8 ± 9.1 years. On standard ECG, arrhythmias were more frequent (32.6%) with ACFA in 5.6% of cases. The prevalence of echocardiographic HVG was 74.8%, predominantly concentric, and was significantly found in hypertensive patients over 10 years of age. During the 24-hour Holter ECG recording, ACFA was the common arrhythmia (30%), episodic in 90.6% of cases and permanent 9.4% and was statistically associated with OG size, sex and age. The Holter ECG detected sustained ventricular tachycardia in 7 patients (6.5%). The Recording was normal 12.1% of the time. Conclusion: Hypertensive heart disease is the first of the cardiac complications of hypertension. The Holter ECG is a tool for the detection of fatal severe paroxysmal events that go unnoticed on the surface ECG such as AC/AF, sustained ventricular tachycardias.
Highlights
Cardiac damage during high blood pressure is referred to as hypertensive cardiopathies (HC)
Left ventricular hypertrophy (LVH) is the first detectable marker of the cardiac repercussions of hypertension, objectified by the electrocardiogram (ECG) or cardiac echocardiography and constitutes an infra-clinical cardiac damage known as target organ damage [2]
The LVH induced by hypertension favours the occurrence of silent ischaemia, conduction disorders and arrhythmias especially ventricular arrhythmias, which are a frequent source of sudden death [2, 3]
Summary
Cardiac damage during high blood pressure (hypertension) is referred to as hypertensive cardiopathies (HC). Left ventricular hypertrophy (LVH) is the first detectable marker of the cardiac repercussions of hypertension, objectified by the electrocardiogram (ECG) or cardiac echocardiography and constitutes an infra-clinical cardiac damage known as target organ damage [2]. Atrial arrhythmias entail a double risk: hemodynamic by chronic or paroxysmal HF such as acute pulmonary edema (APE) and systemic embolic [2]. These rhythm and conduction disorders are on one hand secondary to the infra-clinical cardiac damage of hypertension and are unrecognized, and on the other hand, they are often paroxysmal and fleeting disorders. This work proposes to evaluate the 24-hour Holter ECG recording during HC in order to highlight these fleeting rhythm disorders in hypertensive patients
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