The Influence of Left Ventricular Hypertrophy on Ischaemia and Heart Rhythm Disturbances in Patients with Primary Arterial Hypertension

Abstract

Background The aim of the study was to assess the influence of the left ventricle (LV) mass and the nature of heart muscle hypertrophy on the frequency and lasting time of ischaemia and rhythm disturbances in patients with primary arterial hypertension (PAH).
Methods Two hundred patients with essential hypertension were alotted into 4 groups: group 0 - control, without LV hypertrophy, group I -patients with posterior wall hypertrophy, group II patients with interventricular septum hypertrophy, group III - patients with concentric hypertrophy. Diagnostic methods included ECG, Holter monitoring and echocardiography (single- and two- dimensional with Doppler).
Results LV mass as well as LV mass index were significantly increased in groups with LV hypertrophy - 292-338 and 146-176 g/m2 respectively in the groups, with the highest value in group III. The percentage of patients exhibiting ischaemia in 24h Holter monitoring was different among the groups. in groups I, II, III - 45-68%, being 32% in the control group. The average ischaemia time was the longest in group III - 135 min and the shortest in group 0- 84 min. Ventricular heart rhythm disturbances Lown class III-IV occurred only in groups with LV hypertrophy (65-75% of patients). Atrial fibrillation was registered in group II (27% of the patients).
Conclusion The time of ischaemia, its frequency as well as ventricular heart rhythm disturbances increase with the increase of LV mass. LV hypertrophy and particulary interventricular septum hypertrophy in patients with PAH result in spontaneous atrial fibrillation episodes.