Farklı Sol Ventriküler Geometrik Paterne Sahip Hipertansif Hastalarda Frontal QRS-T Açısının Değerlendirlmesi

Abstract

Amaç: Hipertansif kalp hastalığının değerlendirilmesinde Sol ventrikül (SV) yapısının ve fonksiyonunun incelenmesi, kardiyovasküler morbidite ve mortalite hakkında önemli bilgiler sağlar.Frontal QRS-T açısı (fQRSTa), miyokardiyal depolarizasyon ve repolarizasyon arasındaki heterojenliği ölçmek için kullanılan yeni bir yöntemdir. Bu çalışmanın temel amacı, hipertansiyonlu (HT) hastalarda farklı SV geometrik paternleri ile fQRSTa arasındaki ilişkiyi incelemektir. Gereç ve Yöntemler: Kardiyoloji polikliniğine başvuran ardışık 273 hipertansiyon hastası çalışmaya dahil edildi. Tüm hastalar transtorasik ekokardiyografi ile değerlendirildi ve SV geometrik yapısına göre normal geometri (grup 0), konsantrik yeniden şekillenme (grup 1) ve konsantrik veya eksantrik hipertrofi (grup 2) olarak üç gruba ayrıldı. FQRSTa, frontol düzlem QRS aksı ile T dalga aksı arasındaki mutlak açı farkı olarak tanımlandı. Bulgular: FQRSTa'sı grup 0 ile karşılaştırıldığında, grup 1'de (12 [6 - 19] - 17 [12 - 24], p = 0.023) ve grup 2'de (12 [6 - 19] - 39 [28 – 54], p <0.001) anlamlı olarak daha yüksekti. Ayrıca, fQRSTa grup 2'de grup 1'den daha yüksekti (p <0.001). Korelasyon analizi, fQRSTa ve LV geometrisi arasında anlamlı bir korelasyon ortaya çıkardı (r = 0.525, p <0.001). Çoklu lineer regresyon analizi, fQRSTa'nın LV geometrisi ile bağımsız olarak ilişkili olduğunu ortaya çıkarmıştır (β = 0.257, p <0.001). Sonuç: SV hipertrofisi olan hastaların, normal ventrikül veya konsantrik yeniden şekillenme olanlara kıyasla daha geniş fQRSTa ve daha uzun QT süresine sahip olduğu bulundu

Keywords

• Sol ventrikül geometrisi;
• frontal QRS-T açısı
• hipertansiyon

The Status of Frontal QRS-T Angle in Hypertensive Patients with Different Left Ventricular Geometry

Abstract

Objective: Assessing left ventricular (LV) structure and function gives information on cardiovascular morbidity and mortality, making it important for evaluating hypertensive heart disease. Frontal QRS-T angle (fQRSTa) is a novel approach to quantify the heterogeneity between myocardial depolarization and repolarization. The main purpose here was to define the correlation between different LV geometric patterns and fQRSTa in patients with hypertension (HT). Materials and Methods: 273 patients with hypertension who admitted to the cardiology out-patient clinic were enrolled consecutively. All patients were evaluated by transthoracic echocardiography and classified into three groups based on LV hypertensive geometry as normal geometry (group 0), concentric remodeling (group 1), and concentric or eccentric hypertrophy (group 2). The fQRSTa was defined as the absolute angle difference between frontal plane QRS axis and T wave axis. Results: Compared with group 0, fQRSTa was higher in group 1 (12 [6 – 19] vs. 17 [12 – 24], p=0.023) and group 2 (12 [6 – 19] vs. 39 [28 – 54], p<0.001). Also, fQRSTa was higher in group 2 than group 1 (p<0.001). Correlation analysis revealed a significant correlation between fQRSTa and LV geometry (r=0.525, p<0.001). Multiple linear regression analysis revealed that fQRSTa was independently correlated with LV geometry (β=0.257, p<0.001). Conclusion: Patients with LVH were found to have wider fQRSTa and longer QT duration compared to those with normal ventricles or concentric remodeling.

Keywords

• : Left ventricular geometry
• frontal QRS-T angle
• hypertension

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