Relationship Of Left Ventricular Systolic Synchrony To Tpe Interval In Essential Hypertension

Background Essential hypertension is a common cardiovascular disease.Long-term high blood pressure leads to myocardial remodeling and reduces myocardial systolic synchronicity which makes the function of myocardial contractility decreased.At the same time, Long-term high blood pressure leads to the increase of transmural dispersion of repolarization(TDR) and then makes it easier for the occurrence of ventricular arrhythmias. Studies have found that the incidence of ventricular arrhythmias was increased in patients with hypertrophic cardiomyopathy. Furthermore,myocardial systolic synchronicity was decreased and TDR was increased in patients with hypertrophic cardiomyopathy. Myocardial systolic synchronicity and TDR were relevant in some extent. However, few researches were found about the relationship of myocardial systolic synchronicity and TDR in essential hypertension. So, in this study,we investigated the the relationship of myocardial systolic synchronicity and TDR in essential hypertension. Real-time three-dimensional echocardiography(RT-3DE) is a new means to determine myocardial systolic synchronicity, with the ability of reflecting the movement of the ventricle real-timely and stereoscopically. So, in this study,RT-3DE was used to determine myocardial systolic synchronicity. Tpe interval refers to the interval from T wave peak to T wave end and is considered a new index to reflect TDR. So, in this study, Tpe interval was used to determine TDR in essential hypertension. In all, in this study, we use RT-3DE and Tpe interval to investigate the relationship of myocardial systolic synchronicity and TDR in essential hypertension.Objective To evaluate the relationship of left ventricular systolic synchrony to Tpe interval in essential hypertension.Methods 40 healthy persons and 196 patients with essential hypertension were chosen,including 44 cases of normal geometry, 45 cases of concentric remodeling, 58 cases of concentric hypertrophy and 49 cases of eccentric hypertrophy. Parameters about left ventricular systolic synchrony were acquired by RT-3DE, including the standard deviation(systolic dyssynchrony index, SDI) and the maximum difference(Tmsv16-Dif%, DIF) of left ventricular 16 segment systolic volume peak time respectively. Tpe interval and corrected Tpe(Tpec) interval were acquired by ECG. All parameters were compared between groups. The correlation between left ventricular systolic synchrony parameters and Tpe interval and the correlation between left ventricular systolic synchrony parameters and Tpec were analyzed.Results Compared with normal control group, SDI and DIF of normal geometry group were increased(P ﹤ 0.05),but there was no significantly difference in Tpe interval and Tpec between normal control group and normal geometry group. All parameters except Tpec in concentric remodeling group were higher than those in normal control group(P﹤0.05). All parameters in concentric hypertrophy group and eccentric hypertrophy group were higher than those in normal control group(P﹤0.05).The differences of all parameters between normal geometry group and concentric remodeling group were not significant(P>0.05). Compared with normal geometry group, all parameters were increased in concentric hypertrophy group and eccentric hypertrophy group(P ﹤ 0.05).Compared with concentric remodeling group, all parameters were increased in concentric hypertrophy group and eccentric hypertrophy group(P ﹤ 0.05).Compared with concentric hypertrophy group, all parameters were increased in eccentric hypertrophy group(P ﹤ 0.05). SDI and DIF had positive correlation with Tpe interval and Tpec respectively(r = 0.56, 0.50 and 0.44, 0.52, all P<0. 01).Conclusion With the aggravation of left ventricular remodeling, left ventricular systolic dyssynchrony and Tpe interval gradually increased in patients with essential hypertension. Moreover, there is a positive correlation between left ventricular systolic dyssynchrony and Tpe interval.