Heart rate turbulence in patients with essential hypertension and different patterns of left ventricular geometry and hypertrophy

Abstract

Background Heart rate turbulence analysis is a non-invasive method enabling to estimate sudden cardiac death risk. The aim of the study was to estimate heart rate turbulence parameters in patients with essential hypertension with regard to different geometry and types of left ventricular hypertrophy.
Material and methods Studies were performed in a group of 44 people: 24 women (54.2 ± 10.7 years old) and in 20 men (51.9 ± 9.5 years old) with essential hypertension. All patients were divided according to left ventricular mass index (LVMI) and relative wall thickness (RWT) measured by echocardiography into four groups: normal geometry (n = 11), concentric remodelling (n = 10), concentric hypertrophy (n = 15) and eccentric hypertrophy (n = 8). In each patient 24-hour ECG Holter recording was performed and then turbulence onset (TO) expressed in % and turbulence slope (TS) expressed in ms/RR interval were estimated.
Results In the group of patients with eccentric hypertrophy parameter TO was significantly higher (–0.65 ± 0.17% vs. –1.44 ± 0.31%; p < 0.01) and parameter TS was significantly lower (4.40 ± 1.91 ms/RR vs. 9.21 ± 2.58 ms/RR; p < 0.001) in comparison to subjects with normal geometry of left ventricular.
Conclusions Heart rate turbulence is decreased in people suffering from essential hypertension with abnormal geometry and left ventricular hypertrophy. The highest decrease in heart rate turbulence in patients with essential hypertension complicated by eccentric hypertrophy may show that this group of patients is specially predisposed to cardiovascular complications.