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Dipper ve nondipper hipertansiyonda ventriküler aritmi riskinin elektrokardiyografik parametreler üzerinden değerlendirilmesi

Yıl 2020, Cilt: 11 Sayı: 5, 400 - 407, 30.12.2020
https://doi.org/10.18663/tjcl.672427

Öz

Amaç: Non-dipper hipertansiyon (NDHT) artmış kardiyovasküler mortalite ve morbidite ile ilişkilidir. Çeşitli çalışmalar çok sayıda farklı elektrokardiyografik parametrenin bu amaçla kullanılabileceğini göstermektedir. Özellikle bazı elektrokardiyografik repolarizasyon parametreleri ve 24 saatlik holter kayıtlarından elde edilen bazı özel parametreler sıklıkla kullanılmıştır. Bu çalışmada amaç dipper hipertansiyonlu (DHT) ve NDHT hastalarda ventriküler aritmi riskinin bu elektrokadiyografik parametrelerin çoğunun birlikte kullanılarak değerlendirilmesidir.
Gereç ve Yöntemler: Çalışmaya esansiyel hipertansiyon tanısıyla izlenen 220 hasta alındı. Hastalar 24 saatlik ambulatuvar kan basıncı izlemesi sonuçlarına göre iki grupta değerlendirildi. Sistolik ve/veya diyastolik kan basıncı gece değerleri ortalaması gündüz değerleri ortalamasından %10 veya daha fazla düşük olanlar DHT grubuna, %10’dan az düşük olanlar NDHT grubuna alındı. İki grubun kan basıncı, ekokardiyografi, laboratuar verileri, EKG ve 24 saatlik ritim holter kaydından elde edilen kalp hızı değişkenliği (KHD) ve kalp hızı türbülansı (KHT) verileri karşılaştırıldı.
Bulgular: Demografik bulgular, laboratuar verileri ve ekokardiyografik veriler normal dağılıma uymakta idi ve gruplar arasında anlamlı fark yoktu. Her iki grup arasında sol ventrikül kitle indeksi açısından fark saptanmadı (p=0,280). QT, QT dispersiyonu, KHD, KHT parametrelerinde de istatistiksel anlamlı fark tespit edilememesine rağmen ventriküler aritmi riski açısından verilerin DHT lehine olduğu görüldü. Ayrıca NDHT' da otonom fonksiyonlarda sempatik sistem lehine baskınlığı teyit edecek şekilde ortalama kalp hızı istatistiksel olarak anlamlı olacak şekilde daha yüksek bulundu.
Sonuç: Sol ventrikül çapları ve kitleleri bakımından aralarında anlamlı fark olmayan hipertansif hastalar, dipper ve non-dipper olarak ayrıldığında elektrokardiyografik ventriküler aritmi öngördürücüleri bakımından veriler iki grup arasında dipper lehine olmasına karşın bu fark istatistiksel olarak anlamlı düzeye ulaşmamıştır.

Proje Numarası

14-KAEK-208

Kaynakça

  • 1. Le Heuzey JY, Guize L. Cardiac prognosis in hypertensive patients: Incidence of sudden death and ventricular arrhythmias. Am J Me 1988; 84: 65-73.
  • 2.World Health Organization. https: //www. who. int /cardiovascular_diseases/ publications/ global_brief_hypertension/en/ A global brief on Hypertension. Silent killer, global public health crisis. World Health Day 2013. WHO.Accessed March 10, 2019.
  • 3. Perloff D, Sokolow M, Cowan R. The prognostic value of ambulatory blood pressure. JAMA 1983; 249: 2792-800.
  • 4. Seo WS, Oh HS. The circadian rhythms of blood pressure and heart rate in the hypertensive subjects: dippers and non-dippers. Yonsei Med J 2002; 43: 320-8.
  • 5. No authors listed. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation  1996; 93: 1043-65.
  • 6. Sahn DJ, DeMaria A, Kisslo J, Weyman A. For the committee on M-mode standardization of the American Society of Echocardiography Recommendation regarding quantitation in M-mode echocardiographic measurements. Circulation 1978; 58:1055-72.
  • 7. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man: anatomic validation of the method. Circulation 1977; 55: 613-8.
  • 8. Marso SP, Griffin BP, Topol EJ. USA: Cardiovascular Medicine. 2000: 463- 71.
  • 9. Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Stamler J. End stage renal disease in African, American and white man. 16-year MRFIT findings. JAMA 1997; 277: 1293-301.
  • 10. Cobo MF, Gil EB, Maldonado MA, et al. Nocturnal arterial pressure and cardiovascular risk factors in patients with arterial hypertension. Med Clin (Barc) 2000; 114: 85-93.
  • 11. Verdeccia P, Schillaci G, Porcellati C. Dippers versus nondippers. Am. J. Hypertens 1991; 9: 42-4.
  • 12. Kurpesa L. Myocardial ischemia and autonomic activity in dippers and nondippers with coronary artery disease: assessment of normotensive and hypertensive patients. International Journal of Cardiology 2002; 83: 133-42.
  • 13. Garcia-Ortiz L, Gomez-Marcos MA, Martin-Moreiras J, et al. Pulse pressure and nocturnal fall in blood pressure are predictors of vascular, cardiac and renal target organ damage in hypertensive patients (LOD-RISK study). Blood Press Monit 2009; 14: 145-96.
  • 14. Mansoor GA. Sleep actigraphy in hypertensive patients with the nondipper blood pressure profile. Am. J. Hypertens 2002; 16 : 237-79.
  • 15. Verdecchia P, Schillaci G, Guerrieri M et al. Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation 1990; 81:528-64.
  • 16. Tsioufis C, Antoniadis D, Stefanadis C et al. Relationships between new risk factors and circadian blood pressure variation in untreated subjects with essential hypertension. Am J Hypertens 2002; 15: 600-4.
  • 17. Grandi AM, Broggi R, Jessula A et al. Relation of extent of nocturnal blood pressure decrease to cardiovascular remodeling in never treated patients with essential hypertension. Am J Cardiol 2002; 89: 1193-8.
  • 18. Maheswari VD, Girish M. QT dispersion as marker of left ventricular mass in essential hypertension. Indian Heart J 1988; 50: 414-21.
  • 19. Mayet C, Kanagratham P, Shahi M et al. QT dispersion in athlethic left ventricular hypertrophy. Am Heart J 1999; 137: 678-759.
  • 20. Cavallini B, Perri V, Sali M. Dispersion of QT interval inarterial hypertension with left ventricular hypertrophy. Minerva Cardioangiol 1996; 44 : 45-53.
  • 21. Gupta P, Patel C, Patel H et al. T(pe)/ QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008; 41: 567-641.
  • 22. Erikssen G, Liestol K, Gullestad L, Haugaa KH, Bendz B, Amlie JP. The terminal part of the QT interval (T peak to T end): a predictor of mortality after acute myocardial infarction. Ann Noninvasive Electrocardiol 2012; 17: 85-94.
  • 23. Demir M, Uyan U. Evaluation of Tp-e interval and Tp-e/QT ratio in patients with nondipper hypertension. Clin Exp Hypertens 2013; 36: 285-94.
  • 24. Poanta L, Cerghizan A, Pop D. Blood pressure pattern and heart rate variability in normotensive patients with type 2 diabetes mellitus. Rom J Intern Med .Rev Roum Med Intern 2010; 48: 321–8.
  • 25. Dauphinot V, Gosse P, Kossovsky MP et al. Autonomic nervous system activity is independently associated with the risk of shift in the non-dipper blood pressure pattern. Hypertens Res 2010; 33: 1032–9.
  • 26. Ragot S, Herpin D, Siche JP, Ingrand P, Mallion JM. Autonomic nervous systemactivity in dipper and non-dipper essential hypertensive patients. What about sex differences? J Hypertens 1999; 17: 1805- 16.
  • 27. Mrowka R, Persson PB, Theres H, Patzak A. Blunted arterial baroreflex causes “pathological” heart rate turbulence. Am J Physiol Regul Integr Comp Physiol 2000; 279: 1171-6.
  • 28. Francis J, Watanabe MA, Schmidt G. Heart rate turbulence: a new predictor for risk of sudden cardiac death. Ann Noninvasive Electrocardiol 2005; 100 :102–11.
  • 29. Priori SG, Blomström-Lundqvist C, Mazzanti A et al. Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J 2016; 17: 108-78.
  • 30. Erdem A, Uenishi M, Küçükdurmaz Z et al . Cardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-hypertensive Subjects. Clinical and Experimental Hypertension 2013; 35: 102-9

The evaluation of ventricular arrhythmia risk by using electrocardiographic parameters in patients with dipper and non-dipper hypertension

Yıl 2020, Cilt: 11 Sayı: 5, 400 - 407, 30.12.2020
https://doi.org/10.18663/tjcl.672427

Öz

Aim: Non-dipper hypertension (NDHT) is associated with increased cardiovascular mortality. Lots of different electrocardiographic parameters can be used for this purpose. Some electrocardiographic repolarization parameters and some particular parameters obtained from 24 hours holter recordings frequently were used. The aim of this study was to evaluate ventricular arrhythmia risk by using most of this electrocardiographic parameters in patients with dipper hypertension (DHT) and NDHT.
Material and methods: 220 patients with hypertension were included this study. Patients were divided into two groups as DHT and NDHT according to the 24 hours ambulatory blood pressure monitoring. Two groups were compared with electrocardiography and echocardiography parameters and also were compared with heart rate variability (HRV) and heart rate turbulence (HRT) parameters.
Results: There were no significant differences between DHT and NDHT groups with regard to demographic and laboratory datas. Also echocardiography parameters normally distributed and have no significant differences between two groups. There were no significant differences between DHT and NDHT groups with regard to left ventricular mass index (p=0.280). Although QT, QT dispersion, HRV and HRT parameters differences were not statistically significant , results were in favour of DHT in terms of ventricular arrhythmia risk.
Conclusion: When hypertensive patients having no statistically significant differences in terms of left ventricular diamaters and left ventricular mass between them were divided as DHT and NDHT; there were no statistically significant differences between two groups with regard to electrocardiographic ventricular arrhythmia parameters although results were in favour of DHT.

Proje Numarası

14-KAEK-208

Kaynakça

  • 1. Le Heuzey JY, Guize L. Cardiac prognosis in hypertensive patients: Incidence of sudden death and ventricular arrhythmias. Am J Me 1988; 84: 65-73.
  • 2.World Health Organization. https: //www. who. int /cardiovascular_diseases/ publications/ global_brief_hypertension/en/ A global brief on Hypertension. Silent killer, global public health crisis. World Health Day 2013. WHO.Accessed March 10, 2019.
  • 3. Perloff D, Sokolow M, Cowan R. The prognostic value of ambulatory blood pressure. JAMA 1983; 249: 2792-800.
  • 4. Seo WS, Oh HS. The circadian rhythms of blood pressure and heart rate in the hypertensive subjects: dippers and non-dippers. Yonsei Med J 2002; 43: 320-8.
  • 5. No authors listed. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation  1996; 93: 1043-65.
  • 6. Sahn DJ, DeMaria A, Kisslo J, Weyman A. For the committee on M-mode standardization of the American Society of Echocardiography Recommendation regarding quantitation in M-mode echocardiographic measurements. Circulation 1978; 58:1055-72.
  • 7. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man: anatomic validation of the method. Circulation 1977; 55: 613-8.
  • 8. Marso SP, Griffin BP, Topol EJ. USA: Cardiovascular Medicine. 2000: 463- 71.
  • 9. Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Stamler J. End stage renal disease in African, American and white man. 16-year MRFIT findings. JAMA 1997; 277: 1293-301.
  • 10. Cobo MF, Gil EB, Maldonado MA, et al. Nocturnal arterial pressure and cardiovascular risk factors in patients with arterial hypertension. Med Clin (Barc) 2000; 114: 85-93.
  • 11. Verdeccia P, Schillaci G, Porcellati C. Dippers versus nondippers. Am. J. Hypertens 1991; 9: 42-4.
  • 12. Kurpesa L. Myocardial ischemia and autonomic activity in dippers and nondippers with coronary artery disease: assessment of normotensive and hypertensive patients. International Journal of Cardiology 2002; 83: 133-42.
  • 13. Garcia-Ortiz L, Gomez-Marcos MA, Martin-Moreiras J, et al. Pulse pressure and nocturnal fall in blood pressure are predictors of vascular, cardiac and renal target organ damage in hypertensive patients (LOD-RISK study). Blood Press Monit 2009; 14: 145-96.
  • 14. Mansoor GA. Sleep actigraphy in hypertensive patients with the nondipper blood pressure profile. Am. J. Hypertens 2002; 16 : 237-79.
  • 15. Verdecchia P, Schillaci G, Guerrieri M et al. Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation 1990; 81:528-64.
  • 16. Tsioufis C, Antoniadis D, Stefanadis C et al. Relationships between new risk factors and circadian blood pressure variation in untreated subjects with essential hypertension. Am J Hypertens 2002; 15: 600-4.
  • 17. Grandi AM, Broggi R, Jessula A et al. Relation of extent of nocturnal blood pressure decrease to cardiovascular remodeling in never treated patients with essential hypertension. Am J Cardiol 2002; 89: 1193-8.
  • 18. Maheswari VD, Girish M. QT dispersion as marker of left ventricular mass in essential hypertension. Indian Heart J 1988; 50: 414-21.
  • 19. Mayet C, Kanagratham P, Shahi M et al. QT dispersion in athlethic left ventricular hypertrophy. Am Heart J 1999; 137: 678-759.
  • 20. Cavallini B, Perri V, Sali M. Dispersion of QT interval inarterial hypertension with left ventricular hypertrophy. Minerva Cardioangiol 1996; 44 : 45-53.
  • 21. Gupta P, Patel C, Patel H et al. T(pe)/ QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008; 41: 567-641.
  • 22. Erikssen G, Liestol K, Gullestad L, Haugaa KH, Bendz B, Amlie JP. The terminal part of the QT interval (T peak to T end): a predictor of mortality after acute myocardial infarction. Ann Noninvasive Electrocardiol 2012; 17: 85-94.
  • 23. Demir M, Uyan U. Evaluation of Tp-e interval and Tp-e/QT ratio in patients with nondipper hypertension. Clin Exp Hypertens 2013; 36: 285-94.
  • 24. Poanta L, Cerghizan A, Pop D. Blood pressure pattern and heart rate variability in normotensive patients with type 2 diabetes mellitus. Rom J Intern Med .Rev Roum Med Intern 2010; 48: 321–8.
  • 25. Dauphinot V, Gosse P, Kossovsky MP et al. Autonomic nervous system activity is independently associated with the risk of shift in the non-dipper blood pressure pattern. Hypertens Res 2010; 33: 1032–9.
  • 26. Ragot S, Herpin D, Siche JP, Ingrand P, Mallion JM. Autonomic nervous systemactivity in dipper and non-dipper essential hypertensive patients. What about sex differences? J Hypertens 1999; 17: 1805- 16.
  • 27. Mrowka R, Persson PB, Theres H, Patzak A. Blunted arterial baroreflex causes “pathological” heart rate turbulence. Am J Physiol Regul Integr Comp Physiol 2000; 279: 1171-6.
  • 28. Francis J, Watanabe MA, Schmidt G. Heart rate turbulence: a new predictor for risk of sudden cardiac death. Ann Noninvasive Electrocardiol 2005; 100 :102–11.
  • 29. Priori SG, Blomström-Lundqvist C, Mazzanti A et al. Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J 2016; 17: 108-78.
  • 30. Erdem A, Uenishi M, Küçükdurmaz Z et al . Cardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-hypertensive Subjects. Clinical and Experimental Hypertension 2013; 35: 102-9
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Makale
Yazarlar

Çağrı Zorlu 0000-0003-4085-8151

Metin Karayakalı 0000-0002-9040-7992

Kayihan Karaman 0000-0001-6915-2940

Arif Arısoy 0000-0002-0077-1310

Ataç Çelik 0000-0002-1175-2000

Proje Numarası 14-KAEK-208
Yayımlanma Tarihi 30 Aralık 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 11 Sayı: 5

Kaynak Göster

APA Zorlu, Ç., Karayakalı, M., Karaman, K., Arısoy, A., vd. (2020). The evaluation of ventricular arrhythmia risk by using electrocardiographic parameters in patients with dipper and non-dipper hypertension. Turkish Journal of Clinics and Laboratory, 11(5), 400-407. https://doi.org/10.18663/tjcl.672427
AMA Zorlu Ç, Karayakalı M, Karaman K, Arısoy A, Çelik A. The evaluation of ventricular arrhythmia risk by using electrocardiographic parameters in patients with dipper and non-dipper hypertension. TJCL. Aralık 2020;11(5):400-407. doi:10.18663/tjcl.672427
Chicago Zorlu, Çağrı, Metin Karayakalı, Kayihan Karaman, Arif Arısoy, ve Ataç Çelik. “The Evaluation of Ventricular Arrhythmia Risk by Using Electrocardiographic Parameters in Patients With Dipper and Non-Dipper Hypertension”. Turkish Journal of Clinics and Laboratory 11, sy. 5 (Aralık 2020): 400-407. https://doi.org/10.18663/tjcl.672427.
EndNote Zorlu Ç, Karayakalı M, Karaman K, Arısoy A, Çelik A (01 Aralık 2020) The evaluation of ventricular arrhythmia risk by using electrocardiographic parameters in patients with dipper and non-dipper hypertension. Turkish Journal of Clinics and Laboratory 11 5 400–407.
IEEE Ç. Zorlu, M. Karayakalı, K. Karaman, A. Arısoy, ve A. Çelik, “The evaluation of ventricular arrhythmia risk by using electrocardiographic parameters in patients with dipper and non-dipper hypertension”, TJCL, c. 11, sy. 5, ss. 400–407, 2020, doi: 10.18663/tjcl.672427.
ISNAD Zorlu, Çağrı vd. “The Evaluation of Ventricular Arrhythmia Risk by Using Electrocardiographic Parameters in Patients With Dipper and Non-Dipper Hypertension”. Turkish Journal of Clinics and Laboratory 11/5 (Aralık 2020), 400-407. https://doi.org/10.18663/tjcl.672427.
JAMA Zorlu Ç, Karayakalı M, Karaman K, Arısoy A, Çelik A. The evaluation of ventricular arrhythmia risk by using electrocardiographic parameters in patients with dipper and non-dipper hypertension. TJCL. 2020;11:400–407.
MLA Zorlu, Çağrı vd. “The Evaluation of Ventricular Arrhythmia Risk by Using Electrocardiographic Parameters in Patients With Dipper and Non-Dipper Hypertension”. Turkish Journal of Clinics and Laboratory, c. 11, sy. 5, 2020, ss. 400-7, doi:10.18663/tjcl.672427.
Vancouver Zorlu Ç, Karayakalı M, Karaman K, Arısoy A, Çelik A. The evaluation of ventricular arrhythmia risk by using electrocardiographic parameters in patients with dipper and non-dipper hypertension. TJCL. 2020;11(5):400-7.


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