Left ventricular hypertrophy predicts outcome of hypertension regardless of the type of ventricular arrhythmia present
| Autor: | Mariana Cúri, C. de Carvalho Frimm, Eduardo M. Krieger, Caio Cesar Jorge Medeiros, Gruppi C, B. M. Trezza |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Comorbidity Left ventricular hypertrophy Risk Assessment Predictive Value of Tests Risk Factors Cause of Death Internal medicine Internal Medicine medicine Humans Prospective Studies cardiovascular diseases Proportional Hazards Models Analysis of Variance business.industry Middle Aged Prognosis medicine.disease Survival Rate Cardiovascular Diseases Echocardiography Hypertension Ventricular Fibrillation Electrocardiography Ambulatory cardiovascular system Cardiology Female Hypertrophy Left Ventricular business |
| Zdroj: | Journal of Human Hypertension. 13:617-623 |
| ISSN: | 1476-5527 0950-9240 |
| Popis: | Left ventricular hypertrophy is associated with an increased cardiovascular mortality in hypertension. A potential role of ventricular arrhythmias is debated but not yet determined. The purpose of this study was to evaluate whether the presence of arrhythmias would ascribe any additional risk to cardiovascular mortality beyond that related to the presence of left ventricular hypertrophy. From November 1988 to February 1991, 40 mild to severe hypertensive patients (mean SBP, DBP 183/117 mm Hg) were submitted to clinical, echocardiographic and electrocardiographic evaluations complemented by 24-h Holter monitoring and then followed until November 1996. The Kaplan-Meier method supplemented by the Cox multiple regression model were performed to identify the variable(s) associated with fatal cardiovascular outcome. Twelve cardiovascular fatalities occurred as a consequence of sudden death (n = 4), stroke (n = 4), heart failure (n = 2) and myocardial infarction (n = 2). In comparison with patients who survived, those dying from cardiovascular causes had a greater percentage of electrocardiographic left ventricular hypertrophy (83 vs 36%, P = 0. 0037) and couplets of ventricular ectopic beats (58 vs 18%, P = 0. 0467). In addition, they showed larger left ventricular diastolic diameter (60 +/- 10 vs 53 +/- 8 mm), mass index (248 +/- 67 vs 154 +/- 57 g/m2) and posterior wall thickness (12 +/- 2 vs 10 +/- 2 mm), as well as shorter left ventricular fractional shortening (0.23 +/- 0.8 vs 0.32 +/- 0.9). Univariate analysis showed that electrocardiographic left ventricular hypertrophy and strain, mass index, end-systolic wall stress, fractional shortening and the presence of couplets were significantly related to cardiovascular mortality. However, only mass index was shown to be independently associated with cardiovascular death. In conclusion, left ventricular hypertrophy predicts cardiovascular outcome, regardless of the presence of other signs of cardiac damage, including ventricular arrhythmia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|