PP.33.01] EVALUATION OF HYPERTENSIVE PATIENTS

Abstract

Objective: In practice, it is of utmost importance to predict the outcome for every patient at the beginning of the treatment. The aim was to examine the correlation between non-invasive parameters and outcomes in patients (pts) with essential arterial hypertension (AH) and left ventricular hypertrophy (LVH) during the ten years of follow-up. Design and method: All 124 pts with AH and LVH (57.0 ± 8.0 years; 84 male and 40 female) were examined by means of echocardiography (two independent examiners - Acuson-Sequoia), exercise testing, 24-h Holter monitoring, 24-h ambulatory blood pressure monitoring, heart rate variability and QTc interval dispersion. Patients used regular medicament therapy according to currently valid guidelines during the period of follow-up. Results: During the ten years period of follow-up in 40 (32.3%) pts occurred cardiovascular and cerebrovascular adverse events (AE). At the beginning of the study pts with AE had greater: LVMI (178.9 ± 29.5 g/m2 vs. 165.5 ± 29.5 g/m2; p < 0.05) and left atrial diameter (41.6 ± 6.1 mm vs. 39.2 ± 4.3 mm; p < 0.05). In pts with AE QTc dispersion was greater than in pts without AE (64.1 ± 24.7 ms vs. 54.8 ± 19.4 ms; p < 0.05). In pts with AE Cornell product was more frequently positive than in pts without AE (35% vs. 22.2%; p < 0.01). Positive Lyon-Sokolow score for left ventricular hypertrophy did not achieve statistical significance (25% vs. 11.9%; p = 0.06). Other non/invasive parameters did not achieve statistical significance. Using multiple linear regression analysis the best predictors of worse prognosis were Cornell product and QTc dispersion greater than 65 ms (standardized coefficient beta: for left atrial diameter 0.234; p < 0.01 and QTc dispersion 0.184; p < 0.05 and for the model: R = 0.314, R2 = 0.099, adjusted R2 = 0.084 standard error of the estimate = 0.449; p < 0.05). Conclusions: Patients with positive Cornell product for left ventricular hypertrophy and greater QTc dispersion, especially greater than 65 ms, have worse outcome during the ten years in spite of regular medical treatment.