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QT interval and dispersion differences between normal and prehypertensive patients: effects of autonomic and left ventricular functional and structural changes [Anatol J Cardiol]
Anatol J Cardiol. 2009; 9(1): 15-22

QT interval and dispersion differences between normal and prehypertensive patients: effects of autonomic and left ventricular functional and structural changes

Mehmet Tolga Doğru1, Mahmut Güneri1, Emine Tireli1, Atila İyisoy4, Ömer Şahin5, Turgay Çelik6
1Department of Cardiology, Faculty of Medicine, University of Kırıkkale, Kırıkkale
2Department of Cardiology, Faculty of Medicine, University of Kırıkkale, Kırıkkale
3Department of Cardiology, Faculty of Medicine, University of Kırıkkale, Kırıkkale
4Department of Cardiology, School of Medicine, Gülhane Military Medical Academy, Ankara, Turkey
5Department of Cardiology, Faculty of Medicine, University of KIrIkkale, KIrIkkale
6Department of Cardiology School of Medicine, Gülhane Military Medical Academy, Etlik, Ankara

Objective: We aimed to investigate the effects of autonomic and left ventricular functional and structural changes on QT interval and dispersion differences between normal and prehypertensive patients. Methods: A total of 291 normotensive patients (<140/90 mmHg) (135 males, age range: 16-75 years, mean age: 45±11 years; 156 females, age range: 17-71 years, mean age 38±10 years) were enrolled into this cross-sectional case-controlled study. Patients were categorized into two groups according to their blood pressure (BP) levels as Group 1 - patients with normal BP (<120/80 mmHg) or Group 2 - patients with prehypertensive BP (120-139/80-89 mmHg). We evaluated autonomic states by using heart rate variability measurements. Left ventricular structure and functions were evaluated by using Doppler echocardiography in both normal and prehypertensive BP groups regarding their effect on QT intervals and QT dispersion. Statistical analyses (Student’s t and Mann-Whitney U tests) were used to evaluate the differences in QT intervals and QT dispersion between the BP groups. Results: There were statistically significant differences between the two BP groups with respect to QT intervals and QT dispersion (for QT min, p<0.001, QTc min, p<0.001 and QT dispersion, p<0.001). We also detected that prehypertensive patients had increased sympathetic activity and slightly impaired left ventricular systolic and diastolic function (for low frequency power / high frequency power ratio -p=0.029, left ventricular ejection fraction - p=0.054, and transmitral peak A wave velocity - p<0.001). Conclusion: QT interval and dispersion differences are present in prehypertension. Moreover, these differences are independent of left ventricular mass. Autonomic changes can be effective on these differences between the patient groups.

Keywords: Hypertension, electrocardiography, echocardiography, ventricular function, autonomic nervous system, repolarization


Mehmet Tolga Doğru, Mahmut Güneri, Emine Tireli, Atila İyisoy, Ömer Şahin, Turgay Çelik. QT interval and dispersion differences between normal and prehypertensive patients: effects of autonomic and left ventricular functional and structural changes. Anatol J Cardiol. 2009; 9(1): 15-22


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