scholarly journals Prognostic value of QTc interval dispersion changes during exercise testing in hypertensive men

2008 ◽  
Vol 136 (1-2) ◽  
pp. 16-21 ◽  
Author(s):  
Dragan Djordjevic ◽  
Branko Lovic ◽  
Marina Deljanin-Ilic ◽  
Stevan Ilic ◽  
Ivan Tasic ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Exercise Testing ◽  
Cardiovascular Events ◽  
Ventricular Hypertrophy ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Qtc Interval ◽  
Qtc Dispersion ◽  
Interval Dispersion

INTRODUCTION The prognostic significance of QTc dispersion changes during exercise testing (ET) in patients with left ventricular hypertrophy is not clear. OBJECTIVE The aim was to study the dynamics of QTc interval dispersion (QTcd) in patients (pts) with left ventricular hypertrophy (LVH) during the exercise testing and its prognostic significance. METHOD In the study we included 55 men (aged 53 years) with hypertensive left ventricular hypertrophy and a negative ET (LVH group), 20 men (aged 58 years) with a positive ET and 20 healthy men (aged 55 years). There was no statistically significant difference in the left ventricular mass index (LVMI) between LVH group and ILVH group (160.9?14.9 g/m2 and 152.8?22.7 g/m2). The first ECG was done before the ET and the second one was done during the first minute of recovery, with calculation of QTc dispersion. The patients were followed during five years for new cardiovascular events. RESULTS During the ET, the QTcd significantly increased in LVH group (56.8?18.0 - 76.7?22.6 ms; p<0.001). A statistically significant correlation was found between the amount of ST segment depression at the end of ET and QTc dispersion at the beginning and at the end of ET (r=0.673 and r=0.698; p<0.01). The QTc dispersion was increased in 35 (63.6%) patients and decreased in 20 (36.4%) patients during the ET. Three patients (5.4%) in the first group had adverse cardiovascular events during the five-year follow-up. A multiple stepwise regression model was formed by including age, LVMI, QTc interval, QTc dispersion and change of QTc dispersion during the ET. There was no prognostic significance of QTc interval and QTc dispersion during five-year follow-up in regard to adverse cardiovascular events, but prognostic value was found for LVMI (coefficient ?=0.480; p<0.001). CONCLUSION The increase of QTc interval dispersion is common in men with positive ET for myocardial ischemia and there is a correlation between QTc dispersion and amount of ST segment depression. The increase of QTc interval dispersion during negative ET in patients with left ventricular hypertrophy has no significant predictive value for adverse cardiovascular events, as shown in our five-year follow-up study, but it requires confirmation by investigation of larger groups of patients.

scholarly journals Predictive value of non-invasive parameters in patients with left ventricular hypertrophy during a five-year follow-up period

2012 ◽  
Vol 140 (9-10) ◽  
pp. 571-576 ◽  
Author(s):  
Dragan Djordjevic ◽  
Ivan Tasic ◽  
Bojana Stamenkovic
Keyword(s):  
Heart Rate ◽  
Left Ventricular Hypertrophy ◽  
Exercise Testing ◽  
Predictive Value ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Stepwise Multiple Regression ◽  
Qtc Interval ◽  
Non Invasive

Introduction. Regardless of other known factors, left ventricular hypertrophy is considered to be a significant factor which correlates with the risk of cardiovascular complications. In practice, it is very important to predict the outcome for every patient at the beginning of the treatment. Objective. The aim of the study was to follow the predictive value of non-invasive parameters obtained at the beginning of the study in patients with essential arterial hypertension and left ventricular hypertrophy who were treated by regular therapy through a five year follow-up period. Methods. Ninety patients (average age 55) with essential hypertension and left ventricular hypertrophy were examined. All patients were studied at baseline after temporary discontinuation of previous antihypertensive therapy. The follow-up period started at the baseline examination and lasted for five years. Adverse cardiovascular events occurred in 15 (16.7%) patients. Results. Non-invasive parameters were tested by stepwise multiple regression analysis. Three examined parameters had predictive value: QTc interval dispersion (beta=0.325, p=0.001), septal wall thickness (beta=0.294, p=0.003) and low increase of the heart rate during exercise testing (beta=-0.202, p<0.04). For this model, adjusted R square=0.203; F3,84=8.406, p<0.0001. Conclusion. In spite of regular medical treatment, patients with larger QTc dispersion, greater septum thickness and lower increase of heart rate during exercise testing showed worse outcome through the follow-up period. These patients should be recognized as early as possible and treated more aggressively.

Left ventricular hypertrophy versus chronic kidney disease as predictors of cardiovascular events in hypertension: a Greek 6-year-follow-up study

2009 ◽  
Vol 27 (4) ◽  
pp. 744-752 ◽  
Author(s):  
Costas Tsioufis ◽  
Elena Vezali ◽  
Dimitris Tsiachris ◽  
Kyriakos Dimitriadis ◽  
Eystathios Taxiarchou ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Left Ventricular Hypertrophy ◽  
Cardiovascular Events ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Follow Up Study

Utility of serial 12-lead electrocardiograms in children with Marfan syndrome

2018 ◽  
Vol 28 (8) ◽  
pp. 1009-1013 ◽  
Author(s):  
Alisa A. Arunamata ◽  
Charles T. Nguyen ◽  
Scott R. Ceresnak ◽  
Anne M. Dubin ◽  
Inger L. Olson ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Marfan Syndrome ◽  
Race And Ethnicity ◽  
Left Atrial ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Qtc Interval ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement

AbstractObjectivesThe goal of this study was to assess the utility of serial electrocardiograms in routine follow-up of paediatric Marfan patients.MethodsChildren ⩽18 years who met the revised Ghent criteria for Marfan syndrome and received a 12-lead electrocardiogram and echocardiogram within a 3-month period were included. Controls were matched by age, body surface area, gender, race, and ethnicity, and consisted of patients assessed in clinic with a normal cardiac evaluation. Demographic, clinical, echocardiographic, and electrocardiographic data were collected.ResultsA total of 45 Marfan patients (10.8 [2.4–17.1] years) and 37 controls (12.8 [1.3–17.1] years) were included. Left atrial enlargement and left ventricular hypertrophy were more frequently present on 12-lead electrocardiogram of Marfan patients compared with controls (12 (27%) versus 0 (0%), p<0.001; and 8 (18%) versus 0 (0%), p=0.008, respectively); however, only two patients with left atrial enlargement on 12-lead electrocardiogram were confirmed to have left atrial enlargement by echocardiogram, and one patient had mild left ventricular hypertrophy by echocardiogram, not appreciated on 12-lead electrocardiogram. QTc interval was longer in Marfan patients compared with controls (427±16 versus 417±22 ms, p=0.03), with four Marfan patients demonstrating borderline prolonged QTc intervals for gender.ConclusionsWhile Marfan patients exhibited a higher frequency of left atrial enlargement and left ventricular hypertrophy on 12-lead electrocardiograms compared with controls, these findings were not supported by echocardiography. Serial 12-lead electrocardiograms in routine follow-up of asymptomatic paediatric Marfan patients may be more appropriate for a subgroup of Marfan patients only, specifically those with prolonged QTc interval at their baseline visit.

scholarly journals Cardiac Amyloidosis with Discordant QRS Voltage between Frontal and Precordial Leads

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 660
Author(s):  
Csilla-Andrea Eötvös ◽  
Roxana-Daiana Lazar ◽  
Iulia-Georgiana Zehan ◽  
Erna-Brigitta Lévay-Hail ◽  
Giorgia Pastiu ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Cardiac Amyloidosis ◽  
Ventricular Hypertrophy ◽  
Low Voltage ◽  
Disease Process ◽  
Left Ventricular ◽  
Clinical Suspicion ◽  
Immunoglobulin Light Chain ◽  
Different Types

Among the different types, immunoglobulin light chain (AL) cardiac amyloidosis is associated with the highest morbidity and mortality. The outcome, however, is significantly better when an early diagnosis is made and treatment initiated promptly. We present a case of cardiac amyloidosis with left ventricular hypertrophy criteria on the electrocardiogram. After 9 months of follow-up, the patient developed low voltage in the limb leads, while still maintaining the Cornell criteria for left ventricular hypertrophy as well. The relative apical sparing by the disease process, as well as decreased cancellation of the opposing left ventricular walls could be responsible for this phenomenon. The discordance between the voltage in the frontal leads and precordial leads, when present in conjunction with other findings, may be helpful in raising the clinical suspicion of cardiac amyloidosis.

Electrocardiographic changes in patients with cardiac rhabdomyomas associated with tuberous sclerosis

2003 ◽  
Vol 13 (3) ◽  
pp. 258-263 ◽  
Author(s):  
Junko Shiono ◽  
Hitoshi Horigome ◽  
Seiyo Yasui ◽  
Tomoyuki Miyamoto ◽  
Miho Takahashi-Igari ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Left Ventricular Hypertrophy ◽  
Tuberous Sclerosis ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Cardiac Rhabdomyoma ◽  
Ventricular Cavity ◽  
Electrocardiographic Changes

Background:Cardiac rhabdomyomas associated with tuberous sclerosis induce various abnormalities in the electrocardiogram. Electrocardiographic evidence of ventricular hypertrophy may appear if the tumour is electrically active. To our knowledge, electrocardiographic evidence of ventricular hypertrophy has been reported only in association with congestive heart failure. Follow-up studies of changes in electrocardiographic findings are also lacking.Methods:We studied 21 consecutive patients with cardiac rhabdomyoma associated with tuberous sclerosis, 10 males and 11 females, aged from the date of birth to 9 years at diagnosis. The mean period of follow-up was 53 months. None of the patients developed congestive heart failure. We evaluated the electrocardiographic changes during the follow-up, and their association with echocardiographic findings.Results:Of the 21 patients, 12 showed one or more abnormalities on the electrocardiogram at presentation, with five demonstrating right or left ventricular hypertrophy. In all of these five cases, the tumours were mainly located in the respective ventricular cavity. In one patient with a giant tumour expanding exteriorly, there was marked left ventricular hypertrophy on the electrocardiogram. Followup studies showed spontaneous regression of the tumours in 12 of 19 patients, with abnormalities still present in only 7 patients. A gradual disappearance of left ventricular hypertrophy as seen on the electrocardiogram was noted in the patient with marked left ventricular hypertrophy at presentation in parallel with regression of the tumour.Conclusions:The presence of cardiac rhabdomyomas in patients with tuberous sclerosis might explain the ventricular hypertrophy seen on the electrocardiogram through its electrically active tissue without ventricular pressure overload or ventricular enlargement, although pre-excitation might affect the amplitude of the QRS complex. Even in cases with large tumours, nonetheless, the electric potential might not alter the surface electrocardiogram if the direction of growth of the tumour is towards the ventricular cavity. In many cases, electrocardiographic abnormalities tend to disappear, concomitant with regression of the tumours.

scholarly journals 1059-24 Physical activity attenuates the risk of stroke in middle-age men with left ventricular hypertrophy: 40-year follow-up (1961–2001) of the Corfu cohort (Seven countries study)

2004 ◽  
Vol 43 (5) ◽  
pp. A15 ◽  
Author(s):  
Demosthenes B Panagiotakos ◽  
Christos Pitsavos ◽  
Christina Chrysohoou ◽  
Alessandro Menotti ◽  
John Skoumas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Middle Age ◽  
Left Ventricular ◽  
Seven Countries Study

Regression of left ventricular hypertrophy in hemodialyzed patients is possible: a follow-up study

2010 ◽  
Vol 43 (4) ◽  
pp. 1161-1169 ◽  
Author(s):  
Şerban Ardeleanu ◽  
Larisa Panaghiu ◽  
Octavian Prisadă ◽  
Radu Sascău ◽  
Luminiţa Voroneanu ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Follow Up Study
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