Electrophysiological remodeling of the heart in patients with arterial hypertension

Abstract

Aim. Study electrocardiographic (ECG) and vectorcardiographic (VCG) indicators for various types of structural-  geometric remodeling of the left ventricle (LV) in patients with arterial hypertension (AH).Material and research methods. The analysis was performed in 336 people, including 264 patients with AH, mean age 61.02 ± 7.61 years and 72 practically healthy individuals (57.18 ± 6.47). The ECG indicators of heart rate and duration of P, QRS, RR, PQ, QT, QT corrected according to the Bazett, Friderici and Sagie formulas (QTCB, QTCF, QTCS) were assessed. Echocardiography was used to calculate myocardial mass (LVMM) and LVMM index (LVMI), relative wall thickness (RWT). In the own plane of the VCG: the area of the QRS loop (SQRS), the magnitude of the geometric vector (maxQRS) were determined.Results. Correlation analysis showed the presence of a positive relationship between LVM and LVMI with SQRS (r = 0.49 and r = 0.38), maxQRS (r = 0.28 and r=0.33) and with QRS duration (r = 0.50 and r = 0.43). The groups of patients with concentric (CG) and eccentric (EH) hypertrophy in comparison with controls and patients with AH without LVH gave significantly higher values of absolute QT, QTCF, QTCS. There was a positive correlation between QT and QTС with LVMM, LVMI and no relationship with RWT.Conclusions. In LVH, the duration of QRS and SQRS in its own plane increased. The highest SQRS values were observed in patients with CG of the left ventricle in comparison with EG. Patients with CG and EG did not differ in QRS duration. In patients with AH and LVH, the duration of absolute and corrected values of the QT interval was significantly longer than in patients without LVH. The QT interval lengthened with an increase in LVMM and LVMI. QT duration did not depend on the type of LV hypertrophy — concentric or eccentric.