LEFT-VENTRICULAR GEOMETRIC PATTERNS AND QT DISPERSION IN UNTREATED ESSENTIAL-HYPERTENSION

The spectrum of left ventricular adaptation to hypertension, different types of hypertrophy patterns, and QT dispersion in different types o f hypertrophy was investigated in 107 patients with untreated essentia l hypertension and 30 age- and gender-matched normal adults studied by 12-derivation electrocardiogram (ECG), two-dimensional, and M-mode ec hocardiography. Left ventricular mass (LVM), body mass index, total pe ripheral resistance (TPR), relative wall thickness (RWT), and QT dispe rsion were found to be statistically significantly higher in the hyper tension group (P < .001 for all). Among hypertensive patients, 41.1% h ad both normal LVM and RWT, here called normal left ventricle in hyper tension; 10.3% had concentric hypertrophy with increased LVM and RWT; 14.95% had eccentric hypertrophy with increased LVM and normal RWT; an d 32.7% had concentric remodeling with normal LVM and increased RWT. E chocardiographically derived cardiac index was higher in the concentri c hypertrophy and eccentric hypertrophy patterns (P = .002 and P < .00 01, respectively), whereas TPR was higher in the concentric hypertroph y and concentric remodeling patterns (P = .017 and .02, respectively). QT dispersion values were found to be increased in the hypertensive g roup (P = .001), whereas similar values were calculated for different types of hypertrophy patterns. We conclude that the more common types of ventricular adaptation to essential hypertension are eccentric hype rtrophy and concentric remodeling. Concentric hypertrophy is found to be associated with both volume and pressure overload, whereas eccentri c hypertrophy is associated with volume overload only and concentric r emodeling is associated with pressure overload. But different left ven tricular geometric patterns seem to have similar effects on QT dispers ion. Am J Hypertens 1998;11:1164-1170 (C) 1998 American Journal of Hyp ertension, Ltd.