Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 9-10, Pages: 571-576
https://doi.org/10.2298/SARH1210571D
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Predictive value of non-invasive parameters in patients with left ventricular hypertrophy during a five-year follow-up period
Đorđević Dragan (Medicinski fakultet, Niš + Institut za lečenje i rehabilitaciju „Niška Banja“, Niš)
Tasić Ivan (Medicinski fakultet, Niš + Institut za lečenje i rehabilitaciju „Niška Banja“, Niš)
Stamenković Bojana (Medicinski fakultet, Niš + Institut za lečenje i rehabilitaciju „Niška Banja“, Niš)
Introduction. Regardless of other known factors, left ventricular hypertrophy
is considered to be a significant factor which correlates with the risk of
cardiovascular complications. In practice, it is very important to predict
the outcome for every patient at the beginning of the treatment. Objective.
The aim of the study was to follow the predictive value of non-invasive
parameters obtained at the beginning of the study in patients with essential
arterial hypertension and left ventricular hypertrophy who were treated by
regular therapy through a five year follow-up period. Methods. Ninety
patients (average age 55) with essential hypertension and left ventricular
hypertrophy were examined. All patients were studied at baseline after
temporary discontinuation of previous antihypertensive therapy. The follow-up
period started at the baseline examination and lasted for five years. Adverse
cardiovascular events occurred in 15 (16.7%) patients. Results. Non-invasive
parameters were tested by stepwise multiple regression analysis. Three
examined parameters had predictive value: QTc interval dispersion
(beta=0.325, p=0.001), septal wall thickness (beta=0.294, p=0.003) and low
increase of the heart rate during exercise testing (beta=-0.202, p<0.04). For
this model, adjusted R square=0.203; F3,84=8.406, p<0.0001. Conclusion. In
spite of regular medical treatment, patients with larger QTc dispersion,
greater septum thickness and lower increase of heart rate during exercise
testing showed worse outcome through the follow-up period. These patients
should be recognized as early as possible and treated more aggressively.
Keywords: arterial hypertension, left ventricular hypertrophy, predictive value