Ana Ciobanu, Gary Tse, Tong Liu, Maria V Deaconu, Gabriela S Gheorghe, Adriana M Ilieşiu, Ioan T Nanea. Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension. J Geriatr Cardiol 2017; 14(12): 717-724. doi: 10.11909/j.issn.1671-5411.2017.12.001
Citation:
Ana Ciobanu, Gary Tse, Tong Liu, Maria V Deaconu, Gabriela S Gheorghe, Adriana M Ilieşiu, Ioan T Nanea. Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension. J Geriatr Cardiol 2017; 14(12): 717-724. doi: 10.11909/j.issn.1671-5411.2017.12.001
Ana Ciobanu, Gary Tse, Tong Liu, Maria V Deaconu, Gabriela S Gheorghe, Adriana M Ilieşiu, Ioan T Nanea. Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension. J Geriatr Cardiol 2017; 14(12): 717-724. doi: 10.11909/j.issn.1671-5411.2017.12.001
Citation:
Ana Ciobanu, Gary Tse, Tong Liu, Maria V Deaconu, Gabriela S Gheorghe, Adriana M Ilieşiu, Ioan T Nanea. Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension. J Geriatr Cardiol 2017; 14(12): 717-724. doi: 10.11909/j.issn.1671-5411.2017.12.001
Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension
Department of Internal Medicine and Cardiology, Theodor Burghele Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
Funds:
This paper was supported by the Sectoral Operational Programme Human Resources Development (SOP HRD) 2007–2013, financed from the European Social Fund and by the Romanian Government under the contract number POSDRU/107/1.5/S/82839.
Objective To examine the relationship between Tpeak- Tend interval (Tpe) and Tpe/QT ratio with occurrence of ventricular premature beats (VPBs) and left ventricular remodeling in hypertension.
Methods A total of 52 patients with mild to moderate essential hypertension were included, undergoing echocardiography and 24-hours Holter monitoring. Ventricular remodeling was assessed by left ventricular mass index (LVMI) using the Devereux formula and diastolic function by transmittal E and A wave velocities and E/A ratio. Tpe was measured in the precordial leads. The end of the T wave was set by the method of the tangent to the steepest descending slope of the T wave.
Results Tpe and Tpe/QT in leads V2 (r = 0.33, P = 0.01; r = 0.27, P = 0.04 respectively) and V3 (r = 0.40, P = 0.002; r = 0.40, P = 0.003, respectively) correlated significantly with LVMI. A significant inverse relationship was observed between E/A ratio and QT (r = -0.33, P = 0.01), Tpe in V3 (r = -0.39, P = 0.003) and Tpe/QT in V3 (r = -0.31, P = 0.02). Tpe in V3, V5, mean Tpe and maximum Tpe with cut-off values of 60 ms, 59 ms, 62 ms and 71 ms, respectively, associated with the occurrence of ventricular premature beats.
Conclusions The repolarization parameters Tpe interval and Tpe/QT ratio correlate with LVMI and indices of left ventricular diastolic function and show better predictive values than traditional parameters such as QT interval and QT dispersion. Lead V3 is the best lead for measuring Tpe and Tpe/QT. These ECG indices can therefore be used in clinical practice to monitor LV remodeling and predict occurrence of VPBs.