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

Krystyna Stec-Michalska, Cezary Guga, Aleksander Goch, Ewa Kaczkowska-Marusik, Zenon Gawor, Włodzimierz Kuś, Marek Łukin, Jan Henryk Goch


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.


primary arterial hypertension; left ventricular hypertrophy; ischaemia; arrhythmias

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