CORRELATION OF SIGNAL AVERAGED ECG PARAMETERS WITH LEFT VENTRICULAR MASS INDEX IN PATIENTS WITH SYSTEMIC ARTERIAL HYPERTENSION
Background: Signal averaged ECG is a high-resolution electrocardiography which detects ventricular late potentials in patients susceptible to ventricular arrhythmias. Ventricular late potentials are identified on the basis of three parameters detected on signal averaged ECG. This study was planned to determine the correlation of signal averaged ECG parameters with left ventricular mass index in hypertensive patients. Methods: Sixty-four patients with systemic arterial hypertension were enrolled in the study. Patients with acute or old myocardial infarction, diabetes mellitus, cerebrovascular accident, heart failure, structural heart disease, bundle branch block and cardiomyopathies were excluded. Holter monitors (DMS 300 4L) were used to obtain 3 channel signal averaged ECG recording. CardioScan premium luxury software was used for analysis of ventricular late potentials. Results: There were 49 (76.6%) males and 15 (23.4%) female patients (n=64) with mean age of 60Â±11.83 years. Eleven patients (17.2%) had ventricular late potentials whereas 53 (82.8%) were without them. The mean values for filtered QRS complex, low amplitude signals, root mean square voltage, noise and left ventricular mass index were 108.52Â±23.63 ms, 28.81Â±20.78 ms, 92.17Â±51.02 Âµv, 0.29Â±0.26 Âµv and 140.48Â±68.26 g/m2 respectively. Left ventricular mass index was significantly and positively correlated with filtered QRS complex (p<0.001) and low amplitude signals (p=0.03) whereas the correlation with root means square voltage was not significant (p=0.84). Left ventricular mass index had significant and positive correlation with ventricular late potentials (p=0.009). Conclusion: Patients with higher left ventricular mass index are at greater risk of developing ventricular late potentials which are reflective of ventricular arrhythmias. In hypertensive patients with increased left ventricular mass index the arrhythmogenesis seems to be more related to duration of the cardiac signal as compared to its voltage.
Keywords: Ventricular late potentials, signal averaged ECG, systemic arterial hypertension, left ventricular mass index
Pak J Physiol 2018;14(1):19â€“22
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