Abstract
Introduction. Arterial hypertension is associated with electric instability of the myocardium and the development of fatal ventricular arrhythmias. One of the main causes for the electric instability of the myocardium is the in homogeneity of the ventricular repolarization processes, which can be estimated by studying QT interval duration and dispersion. Objectives.To study the dependence of QT interval (QTc) duration on the level of blood pressure in patients with arterial hypertension using a standard ECG recording and an ambulatory ECG monitoring. Materials and methods. Were examined147 patients, 124 of which with arterial hypertension and 23 without arterial hypertension. Patients were divided into 5 groups according to their blood pressure level: group 1 – normal or elevated blood pressure on a background of antihypertensive therapy: 56 patients (38.1 %), group 2 –grade 1 hypertension; 39 patients (26, 5 %), group 3 –grade 2 hypertension: 22 patients (15 %), group 4 –grade 3 hypertension: 7 patients (4.8 %), the fifth group – normal or elevated pressure: 23 patients, which is 15.6 % (comparison group, without arterial hypertension). The study of the dependence of QT interval (QTc) duration on the level of BP was carried out according to the analysis of the data of standard ECG, ECG Holter monitoring and 24-hour blood pressure monitoring. Results. A statistically significant regression dependence of the duration of minimal nocturnal QT intervals and corrected QTc on the stage of arterial hypertension in groups 1 and 4 with p < 0.05 was establishedon the basis of Student’s t-test for independent samples. Conclusions. There was a statistically significant regression dependence of the minimum QT interval at night and the minimum corrected interval QTc at night on the daily level of variability 1 of systolic blood pressure, which indicates a direct dependence of the QT interval and QTc on blood pressure.
Highlights
Arterial hypertension is associated with electric instability of the myocardium and the development of fatal ventricular arrhythmias
Однією з основних причин електричної нестабільності міокарда є негомогенність процесів реполяризації в шлуночках, яку можна оцінити шляхом вивчення тривалості та дисперсії QT інтервалу [11]
J. et al 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society [published correction appears in J Am Coll Cardiol. 2018 Oct 2; 72 (14): 1760]
Summary
Перспективним у подальшому дослідженні вважаємо вивчення залежності тривалості інтервалу QT (QTc) від ступеня ураження органів – мішеней у пацієнтів з АГ. V., Thom S. et al Ambulatory blood pressure monitoring predicts cardiovascular events in treated hypertensive patients – an Anglo-Scandinavian cardiac outcomes trial substudy. 6. Breidthardt T., Christ M., Matti M., et al QRS and QTc interval prolongation in the prediction of longterm mortality of patients with acute destabilised heart failure. Dimopoulos S., Nicosia F., Donati P. et al QT dispersion and left ventricular hypertrophy in elderly hypertensive and normotensive patients. J. et al 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society [published correction appears in J Am Coll Cardiol.
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