PROGNOSTIC VALUE OF ARRHYTHMOGENIC MARKERS IN SYSTEMIC HYPERTENSION

Objective To evaluate the prognostic value of arrhythmogenic markers i n hypertensive patients. Design Two hundred and fourteen hypertensive patients without symptomatic coronary disease, systolic dysfunction, e lectrolyte disturbances or anti-arrhythmic therapy were included. Reco rdings were made of 12-lead standard ECGs with calculations of QT inte rval dispersion, 24 h Holter ECGs (204 patients), echocardiography (18 7 patients) and signal-averaged ECGs (125 patients). Results Baseline data: echocardiographic left ventricular hypertrophy was found in 63 p atients (33.7%), non-sustained ventricular tachycardia (Lown class IV b) in 33 patients (16.2%), ventricular late potentials in 27 patients (21.6%). Mortality: after a mean follow-up of 42.4 +/- 26.8 months, gl obal mortality was 11.2% (24 patients), cardiac mortality 7.9% (17 pat ients), sudden death 4.2% (nine patients). Univariate variate analysis : predictors of global, cardiac and sudden death were age greater than or equal to 65 years, ECC strain pattern, Lown class IV b and QT inte rval dispersion >80 ms (P<0.01). Left ventricular mass index was close ly related to cardiac mortality (P=0.002). Multivariate analysis: only Lown class nl b was an independent predictor of global (RR 2.6, 95% C I 1.2-6.0) and cardiac mortality (RR 3.5, 95% CI 1.2-9.7). Conclusion In hypertensive patients, non-sustained ventricular tachycardia has a prognostic value.