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European Heart Journal 1997 18(9):1484-1491;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Prognostic value of arrhythmogenic markers in systemic hypertension

M. Galinier*,, S. Balanescu{dagger}, J. Fourcade*, M. Dorobantu{dagger}, J. P. Albenque*, P. Massabuau*, J. P. Doazan*, J. M. Fauvel* and J. P. Bounhoure*

*Cardiology Department, Rangueil University Hospital Toulouse, France
{dagger}Cardiology Department, University Hospital of Bucharest Romania

revised 17 December 1996; accepted 19 December 1996.

Correspondence: Dr Michel Galinier, MD, PhD, Cardiology Department, Rangueil University Hospital, 1, Av. Jean Poulhes, 31054 Toulouse, France

Abstract

OBJECTIVE: To evaluate the prognostic value of arrhythmogenic markers in hypertensive patients.

DESIGN: Two hundred and fourteen hypertensive patients without symptomatic coronary disease, systolic dysfunction, electrolyte disturbances or anti-arrhythmic therapy were included. Recordings were made of 12-lead standard ECGs with calculations of QT interval dispersion, 24 h Holter ECGs (204 patients), echocardiography (187 patients) and signal-averaged ECGs (125 patients).

RESULTS: Baseline data: echocardiographic left ventricular hypertrophy was found in 63 patients (33·7%), non-sustained ventricular tachycardia (Lown class IV b) in 33 patients (16·2%), ventricular late potentials in 27 patients (21·6%). Mortality: after a mean follow-up of 42·4±26·8 months, global mortality was 11·2% (24 patients), cardiac mortality 7·9% (17 patients), sudden death 4·2% (nine patients). Univariate analysis: predictors of global, cardiac and sudden death were age ≥65 years, ECG strain pattern, Lown class IV b and QT interval dispersion >80 ms (P≤0·01). Left ventricular mass index was closely related to cardiac mortality (P=0·002). Multivariate analysis: only Lown class IV b was an independent predictor of global (RR 2·6, 95% CI 1·2–6·0) and cardiac mortality (RR 3·5, 95% CI 1·2–9·7).

CONCLUSION: In hypertensive patients, non-sustained ventricular tachycardia has a prognostic value.

Key Words: Hypertension • left ventricular hypertrophy • QT interval dispersion • 24 h Holter ECG • mortality


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