Prognostic evaluation of QT-dispersion in elderly hypertensive and normotensive patients.
BACKGROUND: QT-corrected interval dispersion (QTcD) is an indirect index of increased heterogeneity of ventricular repolarization. However, the prognostic value of (QTcD) in elderly hypertensive and normotensive patients has not been thoroughly investigated yet. METHODS: The study population consist...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 32; no. 11; pp. 1381 - 1388 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Nov2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105235424&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105235424 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Nov2009 vid: 32 iid: 11 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105235424 2010455688 10.1111/j.1540-8159.2009.02510.x NLM19712075 105235424 ppf: 1381 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Prognostic evaluation of QT-dispersion in elderly hypertensive and normotensive patients. aug: au: Dimopoulos S Nicosia F Turini D Zulli R affil: Clinical Therapeutics, University of Athens, Alexandra Hospital, 41, Evrinomis Street, Zografou, Athens 15771, Greece; stdimop@med.uoa.gr sug: subj: Cardiac Patients Evaluation Electrocardiography Methods Hypertension Diagnosis After Care Aged Aged, 80 and Over Blood Pressure Determination Methods Chi Square Test Cox Proportional Hazards Model Data Analysis Software Descriptive Statistics Electrophysiology Hypertension Etiology Hypertrophy, Left Ventricular Diagnosis Kaplan-Meier Estimator Prognosis T-Tests Aged: 65+ years Aged, 80 & over ab: BACKGROUND: QT-corrected interval dispersion (QTcD) is an indirect index of increased heterogeneity of ventricular repolarization. However, the prognostic value of (QTcD) in elderly hypertensive and normotensive patients has not been thoroughly investigated yet. METHODS: The study population consisted of 60 consecutive patients (34 males/26 females; mean age: 63+/-11 years) with mild to moderate essential arterial hypertension and 48 consecutive age-matched healthy subjects (24 males/24 females; 65+/-16 years). QTcD was measured by a 12-lead electrocardiogram (ECG) as the difference between maximum and minimum QT-interval, corrected for heart rate. Ventricular arrhythmias were recorded by a 24-hour Holter ECG and classified by a modified Lown's score (range: 0-6). Left ventricular mass was measured echocardiographically and indexed by body surface area [left ventricular mass index (LVMI)]. Nine patients were lost during the follow-up period. Patients were followed up for 54+/-9 months, and the primary end-point was the major cardiovascular events (including cardiac mortality). RESULTS: Major cardiovascular events occurred in 22 patients (22%). Patients with QTcD>or=45 ms (n=35) had a higher rate of major cardiovascular events (43% vs 11%; log rank: 14.8; P<0.001), a higher LVMI (146+/-29 vs 104+/-21 g/m2; P<0.001), greater values of systolic and diastolic blood pressure (154+/-16 vs 144+/-18 mmHg; P<0.01 and 92+/-10 vs 88+/-8 mmHg; P<0.05, respectively), a higher number of premature ventricular beats (354+/-870 vs 113+/-301; P<0.05), and a greater Lown's score (3.7+/-1.9 vs 1.4+/-1.8; P<0.05) than patients with QTcD<45 ms. QTcD (>or=or<45 ms) was an independent predictor of major cardiovascular events (odds ratio: 4.9; 95% confidence interval: 2.0-12.1; P=0.001) after adjustment for LVMI, Lown's score (>or=or<3), age (>or=or<65 years), and QTc max (>or=or<437 ms). CONCLUSIONS: QTcD is an independent predictor of major cardiovascular events in elderly hypertensive and normotensive patients and might be used in their risk stratification. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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