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2 results on '"Balanescu S"'

1. [Correlation between QT interval dispersion and ventricular arrhythmia in hypertension]

Author

Balanescu S, Michel GALINIER, Fourcade J, Dorobantu M, Jp, Albenque, Massabuau P, Jm, Fauvel, and Jp, Bounhoure

Subjects
Male, Hypertension, Multivariate Analysis, Electrocardiography, Ambulatory, Tachycardia, Ventricular, Humans, Arrhythmias, Cardiac, Female, Hypertrophy, Left Ventricular, Middle Aged, Aged, Retrospective Studies, Ultrasonography
Abstract

To evaluate the correlation between QT interval dispersion (QTd) and ventricular arrhythmias in hypertensive patients (pts) with or without left ventricular hypertrophy (LVH). A secondary aim was to investigate correlations of QTd with other markers of arrythmogenic propensity: ventricular late potentials (LP) and heart rate variability (HRV).We retrospectively measured the QTd on the 12 standard surface ECG leads in 230 hypertensive pts (94F, 136M; 59.6 +/- 12.7 years old). A 24 hours ECG Holter recording was performed in 218 pts and ventricular arrhythmias were appreciated using the Lown classification. Left ventricular mass was determined by echocardiography (LVM-Devereux formula) and left ventricular mass index (LVMI) were determined in 202 subjects. LP (122 pts) and HRV (55 pts) were investigated.The QTd varied between 20 and 160 msec (57.8 +/- 32.7 msec). The distribution of pts classified using Lown criteria was: 29 pts (13.3%) class O; 106 pts (48.6%) class I; 8 pts (3.6%) class II; 13 pts (6%) class III; 29 pts (13.3%) class IVa; 33 pts (15.1%) class IVb; 116 pts (69.5%) had LVH determined by echocardiography. The QTd was strongly correlated with the Lown classes (p0.0001). The QTd was significantly broader in Lown classes III, IVa and IVb compared to classes O, I and II cumulated (p0.002); there was no difference concerning QTd between Lown classes III, IVa and IVb. The QTd was also correlated with the absolute number of premature ventricular depolarizations/24 hours (p = 0.02; r = 0.16). The 75 pts with an increased LVMI had significantly elevated QTd compared to pts without it (p0.0001). Qtd was correlated with LVMI (r = 0.37; p0.0001). There was no correlation between QTd and the existence of LP (which were correlated with the Lown classes; p0.03) and HRV parameters.Elevated QT interval dispersion is associated with more severe ventricular arrhythmias in hypertensive subjects with LVH. The mechanism of an increased inhomogeneity of repolarisation is probably related to the anatomic modifications induced by LVH. No significant correlation between QTd, LP and HRV was observed.

Published
1996

2. [Prognostic value of ventricular arrhythmia in hypertensive patients].

Author

Galinier M, Balanescu S, Fourcade J, Dorobantu M, Massabuau P, Dongay B, Cabrol P, Fauvel JM, and Bounhoure JP

Subjects
Aged, Arrhythmias, Cardiac mortality, Arrhythmias, Cardiac physiopathology, Electrocardiography, Female, Humans, Hypertension mortality, Hypertension therapy, Hypertrophy, Left Ventricular mortality, Hypertrophy, Left Ventricular physiopathology, Male, Middle Aged, Prognosis, Prospective Studies, Survival Analysis, Ventricular Dysfunction etiology, Ventricular Dysfunction physiopathology, Arrhythmias, Cardiac complications, Hypertension complications, Hypertrophy, Left Ventricular complications
Abstract

Objective: Hypertensive left ventricular hypertrophy (LVH) is associated with increased risk of arrhythmias and mortality. However, no clinical study demonstrated a significant relation between ventricular arrhythmias and mortality in systemic hypertension., Design and Methods: To evaluate the prognostic value of arrhythmogenic markers in systemic hypertension, we included between 1987 and 1993. 214 hypertensive patients, 59.1 +/- 12.8 years old, without symptomatic coronary disease, myocardial infarction, systolic dysfunction, electrolyte disturbances or antiarrhythmic therapy. At inclusion, an ECG, a 24 h Holter ECG (204 patients) with Lown classification of ventricular arrhythmias, an echocardiography (reliable in 187 patients) with left ventricular mass index and ejection fraction calculation, a SAECG (125 patients, enrolled after 1988) with ventricular late potentials (LP) were recorded. QT interval dispersion (QTd) was calculated on 12 leads standard ECG and LVH was appreciated., Results: At baseline echocardiographic LVH was recorded in 63 patients (33.7%) with normal ejection fraction (75 +/- 7.4%). Non-sustained ventricular tachycardia (Lown IVb) was found in 33 pts (16.2%) and LP in 27 patients (21.6%). After a mean follow up of 42.4 +/- 26.8 months, all-cause mortality was 11.2% (24 patients); 17 patients died of cardiac causes (7.9%); of these 9 patients (4.2%) died suddenly. In univariate analysis, age, strain pattern of LVH, advanced Lown classes and abnormal QT dispersion (> 80 ms) were significantly related to global, cardiac and sudden death (p < or = 0.01). Left ventricular mass index was closely related to cardiac mortality (p = 0.002). LP failed to predict mortality. In multivariate analysis, only Lown class IVb was an independent predictor of global and cardiac mortality, increasing the risk of global death 2.6 fold [1.2-6.0] (CI 95%) and the risk of cardiac death 3.5 fold [1.2-9.7] (CI 95%)., Conclusions: In hypertensive patients the presence of non-sustained ventricular tachycardia on 24 h Holter has a prognostic value.

Published
1997

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