Arterial hypertension and stress-induced arrhythmias in coronary heart disease patients
Abstract
To investigate arterial hypertension (AH) influence on stress-induced arrhythmias in coronary heart disease (CRT)) patients, we examined 196 males with previously verified CRT) and various stages of AH. All participants underwent echocardiography, bicycle stress test (BST); corrected cQT(cQT) dispersion at baseline and during BST, as well as recovery time of initial dispersion and ST segment, were calculated. AH, especially severe AH, was a risk factor for stress-induced ventricular extrasystolia (VES) in CHD patients, by promoting left ventricular hypertrophy (LVH) and myocardial electrical heterogeneity. In CHD patients with stress-induced VES, comparing to VES-free individuals, myocardial electric heterogeneity was maximal during stress tests, increasing at the very beginning of the tests. These results can be used in predicting cardiac arrhythmias incidence during physical stress.
About the Authors
L. A. Leshchinsky
Ижевская государственная медицинская академия
Russian Federation
Russian Federation
B. L. Multanovsky
Ижевская государственная медицинская академия
Russian Federation
Russian Federation
A. G. Petrov
Ижевская государственная медицинская академия
Russian Federation
Russian Federation
References
1. Аронов Д.М., Лупанов В.П., Михеева Т.Г. Функциональные пробы в кардиологии. Лекции III, IV. Кардиология 1995; 12: 83-93.
2. Васильева Е.Ю., Артамонов В.Г., Карпман М.Л., Шпектор А.В. Динамика дисперсии корригированного интервала QT при стресс-тесте и его диагностическое значение. Кардиоваскулярная терапия и профилактика 2003; 1: 75-80.
3. Кузин А.И., Камерер О.В., Габбасова Л.А., Дружков М.А. Параметры перфузии миокарда в покое и их клиническая оценка у пациентов с артериальной гипертензией и ишемической болезнью сердца. Российский кардиологический журнал 2004; 2: 16-19.
4. Непомнящих Л.М. Морфогенез важнейших общепатологических процессов в сердце. Новосибирск: Наука, 1991. 352 с.
5. Пшеничников И.Н., Шипилова Т.А., Лаане П.Т. Значение безболевой ишемии в определении ближайшего прогноза у больных ишемической болезнью сердца со стабильной стенокардией. Кардиология 1996; 7: 11-15.
6. Трешкур Т.В. Клинико-электрокардиографическая характеристика ишемических желудочковых аритмий. Вестник аритмологии 2002; 30: 31-40.
7. Шпектор А.В., Артамонов В.Г., Карпман М.Л., Васильева Е.Ю. Диагностическое значение динамики дисперсии интервала QTc при проведении теста с физической нагрузкой у больных ИБС.//Тезисы докладов Росийского национального конгресса кардиологов, 10-12. 10. 2000; 169.
8. Bruyne M.C., Hoes A.W., Kors J.A., et al. QTc dispersion as predicts cardiac mortality in the elderly. Circulation 1998; 97: 467-472.
9. Buxton A.E., Lee K.L., Hafley G.E., et al. Relation of ejection fraction and inducible ventricular tachycardia to mode of death in patients with coronary artery disease: an analysis of patients enrolled in multicenter unsustained tachicardia trial. Circulation, 2002 Nov; 106(19): 2466-2472.
10. Elliott P., Sharma S., Varnava A., et al. Survival after cardiac arrest or sustained ventricular tachycardia in patients with hypertrophic cardiomyopathy. J. Am. Coll. Cardiol. 1999; 33: 1596-1601.
11. Galinier M., Blanescu S., Fourcade J., et al. Prognostic value of arrythmogenic markers in systemic hypertension. Eur. Heart J. 1997; 18: 1484-1491.
12. Fejka M., Corpus R.A., Arends J., et al. Exercise-induced nonsustained ventricular tachycardia: a significant marcer of coronary artery disease? J. Interv. Cardiol. 2002 Jun; 15(3): 231-235.
13. Figueredo E.G., Ohnishi Y., Yoshida F., Yokoyama M. Usefulness of beat-to-beat QT dispersion fluctuation for identification patients with coronary heart disease at risk for ventricular arrhythmias. Am. J. Cardiol. 2001 Dec 1; 88(11): 1235-1239.
14. Fralkis J.P., Pothier C.E., Blackstoun E.H., Lauer M.S. Frequent ventricular ectopy after exercise as a predictor of death. The New England J. of Med. 2003; 9: 781-790.
15. Koide Y., Yotsukura M., Yoshino H., Ishikawa K. Value of QT dispersion in the interpretation of treadmill exercise electrocatdiograms of patients without exercise-induced chest pain ST-segment depression. Am. J. Cardiol. 2000; 85(9): 1094-1099.
16. Members of Sicilian Gambit. New approaches to antiarrhythmic theraphy: emerging therapeutic applications of the cell biology of cardiac aarrhythmias. Cardiovasc. Res. 2001; 52: 345-360.
17. Myeburg R.J., Spooner P.M. Opportunities for sudden death prevention: directions for new clinical and basic research. Cardiovasc. Res. 2001 May; 50(2): 177-185.
18. Wolk R. Arrhythmogenic mechanisms in left ventricular hypertrophy. Europace 2000; 2; 3: 216-223.
Review
For citations:
Leshchinsky L.A., Multanovsky B.L., Petrov A.G. Arterial hypertension and stress-induced arrhythmias in coronary heart disease patients. Russian Journal of Cardiology. 2005;(3):11-15. (In Russ.)
Views:
525
Email this article 