Predictors for the prolonged R wave peak time among patients with arterial hypertension
Yıl: 2021 Cilt: 49 Sayı: 5 Sayfa Aralığı: 387 - 394 Metin Dili: İngilizce DOI: 10.5543/tkda.2021.80540 İndeks Tarihi: 29-01-2022
Predictors for the prolonged R wave peak time among patients with arterial hypertension
Öz: Objective: Hypertension (HT) is prevalent in the general population and is associated with significant cardiovascular adverse events. Major structural and electrical remodeling occurs in the ventricular myocardium in response to the pressure overload. Increased left ventricular mass (LVM) and myocardial fibrosis contribute to the prolongation of the R wave peak time (RWPT), which may indicate electrical remodeling in patients with HT. We evaluated predictors for prolonged RWPT among patients with a previous diagnosis of HT. Methods: Consecutive patients who had a previous diagnosis of arterial HT and presented to the cardiology clinic for routine visit were included in the study. The standard 12- lead surface electrocardiography (ECG) and transthoracic echocardiography (TTE) was performed on all the patients included in the study for evaluating RWPT and the epicardial fat tissue (EFT). The upper limit for the RWPT was accepted as 40 milliseconds (ms). Results: Between February 2019 and February 2020, 453 patients were screened; and of these, 237 were included in the study. The mean age was 62.1±11.2 years, and 41.8% of the included patients were men. The mean RWPT of the study population was 41.9±10.8. The RWPT was prolonged in 55 patients, and the remaining 172 patients had normal RWPT. In the univariate analysis, EFT (Odds ratio [OR] 1.222; 95% confidence interval [CI] 1.077-1386; p=0.002), the left ventricular mass index (LVMI) (OR 1.011; 95% CI 1.001-1.021; p=0.026), and fragmented QRS (fQRS) (OR 2.679; 95% CI 1.433-5.004; p=0.002) were associated with a prolonged RWPT. Multivariate analysis revealed that only EFT (OR 1.211; 95% CI 1.061-1.383; p=0.005) and fQRS (OR 2.796; 95% CI 1.459-5.359; p=0.002) predicted prolonged RWPT. Conclusion: Among the patients with HT, EFT and fQRS predicted prolonged RWPT. These findings may suggest that compared with increased LVM, myocardial fibrosis had a more significant impact on ventricular activation time.
Anahtar Kelime: Arteriyal hipertansiyon hastalarında uzamış R dalgası pik süresi prediktörleri
Öz: Amaç: Hipertansiyon (HT) toplumda oldukça yaygın görülen bir hastalık olup önemli kardiyovasküler sonlanım noktaları ile ilişkilidir. Artan basınç yükü sonrası ventrikül miyokard dokusunda ciddi yapısal ve elektriksel yeniden şekillenme ortaya çıkmaktadır. Hipertansif hastalarda elektriksel yeniden şekillenmenin göstergelerinden biri R dalgası pik süresi uzamasıdır (RWPT) ve bu durumun nedenleri arasında artmış sol ventrikül miyokard kitlesi ile miyokardial fibroz yer almaktadır. Çalışmamızda daha önce HT tanısı bulunan hastalarda uzamış RWPT öngördüren parametreleri araştırmayı amaçladık. Yöntemler: Hipertansiyon tanısı bulunan kardiyoloji polikliniğine rutin kontrol için gelen ardışık hastalar çalışmaya dahil edilmiştir. Standart 12 derivasyonlu yüzey elektrokardiyografi (EKG) ve transtorasik ekokardiyografi (TTE) çalışmaya dahil edilen hastalara RWPT ve EFT değerlendirilmesi amacıyla uygulandı. RWPT için üst sınır 40 milisaniye (ms) olarak belirlendi. Bulgular: Şubat 2019 ile Şubat 2020 arasında 453 hasta çalışma için taranmış olup bunlardan 237’si çalışmaya dahil edilmiştir. Hastaların ortalama yaşının 62.1±11.2 ve %41.8’i erkek olarak görüldü. Çalışmaya dahil edilen hastaların ortalama RWPT değeri 41.9±10.8 olarak bulundu. RWPT 55 hastada uzamış olarak saptanırken kalan 172 hastada normal bulundu. Tek değişkenli analizde EFT (OR, 1.222; 95% CI, 1.077-1386; p=0.002), sol ventrikül kitle indeksi (LVMI) (OR, 1.011; 95% CI, 1.001-1.021; p=0.026) ve fragmente QRS (fQRS) (OR, 2.679; 95% CI, 1.433-5.004; p=0.002) parametrelerinin uzamış RWPT ile ilişkili olduğu bulundu. Çok değişkenli analizde ise EFT (OR, 1.211; 95% CI, 1.061-1.383; p=0.005) ve fQRS (OR, 2.796; 95% CI, 1.459-5.359; p=0.002) parametrelerinin uzamış RWPT’i predikte ettiği gösterildi. Sonuç: Hipertansif hastalarda, EFT ve fQRS uzamış RWPT’ı predikte etmektedir. Bu sonuçlar ventriküler aktivasyon süresi uzamasına miyokardial fibrozun, artmış sol ventrikül kitlesine göre daha etkili olduğunu düşündürebilir
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Çinier G, Yilmaz A, TEKKESIN I, Çetin M (2021). Predictors for the prolonged R wave peak time among patients with arterial hypertension. , 387 - 394. 10.5543/tkda.2021.80540 |
| Chicago | Çinier Göksel,Yilmaz Ahmet Seyda,TEKKESIN Ilker,Çetin Mustafa Predictors for the prolonged R wave peak time among patients with arterial hypertension. (2021): 387 - 394. 10.5543/tkda.2021.80540 |
| MLA | Çinier Göksel,Yilmaz Ahmet Seyda,TEKKESIN Ilker,Çetin Mustafa Predictors for the prolonged R wave peak time among patients with arterial hypertension. , 2021, ss.387 - 394. 10.5543/tkda.2021.80540 |
| AMA | Çinier G,Yilmaz A,TEKKESIN I,Çetin M Predictors for the prolonged R wave peak time among patients with arterial hypertension. . 2021; 387 - 394. 10.5543/tkda.2021.80540 |
| Vancouver | Çinier G,Yilmaz A,TEKKESIN I,Çetin M Predictors for the prolonged R wave peak time among patients with arterial hypertension. . 2021; 387 - 394. 10.5543/tkda.2021.80540 |
| IEEE | Çinier G,Yilmaz A,TEKKESIN I,Çetin M "Predictors for the prolonged R wave peak time among patients with arterial hypertension." , ss.387 - 394, 2021. 10.5543/tkda.2021.80540 |
| ISNAD | Çinier, Göksel vd. "Predictors for the prolonged R wave peak time among patients with arterial hypertension". (2021), 387-394. https://doi.org/10.5543/tkda.2021.80540 |
| APA | Çinier G, Yilmaz A, TEKKESIN I, Çetin M (2021). Predictors for the prolonged R wave peak time among patients with arterial hypertension. Türk Kardiyoloji Derneği Arşivi, 49(5), 387 - 394. 10.5543/tkda.2021.80540 |
| Chicago | Çinier Göksel,Yilmaz Ahmet Seyda,TEKKESIN Ilker,Çetin Mustafa Predictors for the prolonged R wave peak time among patients with arterial hypertension. Türk Kardiyoloji Derneği Arşivi 49, no.5 (2021): 387 - 394. 10.5543/tkda.2021.80540 |
| MLA | Çinier Göksel,Yilmaz Ahmet Seyda,TEKKESIN Ilker,Çetin Mustafa Predictors for the prolonged R wave peak time among patients with arterial hypertension. Türk Kardiyoloji Derneği Arşivi, vol.49, no.5, 2021, ss.387 - 394. 10.5543/tkda.2021.80540 |
| AMA | Çinier G,Yilmaz A,TEKKESIN I,Çetin M Predictors for the prolonged R wave peak time among patients with arterial hypertension. Türk Kardiyoloji Derneği Arşivi. 2021; 49(5): 387 - 394. 10.5543/tkda.2021.80540 |
| Vancouver | Çinier G,Yilmaz A,TEKKESIN I,Çetin M Predictors for the prolonged R wave peak time among patients with arterial hypertension. Türk Kardiyoloji Derneği Arşivi. 2021; 49(5): 387 - 394. 10.5543/tkda.2021.80540 |
| IEEE | Çinier G,Yilmaz A,TEKKESIN I,Çetin M "Predictors for the prolonged R wave peak time among patients with arterial hypertension." Türk Kardiyoloji Derneği Arşivi, 49, ss.387 - 394, 2021. 10.5543/tkda.2021.80540 |
| ISNAD | Çinier, Göksel vd. "Predictors for the prolonged R wave peak time among patients with arterial hypertension". Türk Kardiyoloji Derneği Arşivi 49/5 (2021), 387-394. https://doi.org/10.5543/tkda.2021.80540 |
