Clinical Investigations Effect of Left Ventricular Hypertrophy on Late Potentials in Hypertensive Patients with Normal Coronary Angiograms

Left ventricular hypertrophy (LVH) has an ominous sign on prognosis which is in part due to ventricular arrhythmias. To determine the incidence of ventricular arrhythmias and of late potentials in 51 hypertensive patients (25 male, 26 female, mean age: 56), those with normal coronary angiographic findings were categorized according to echocardiographic criteria into cases with LVH (group 1), and without LVH (group 2). For the evaluation of ventricular arrhythmias, 24-hour ambulatory electrocardiograms (ECG) were recorded in 51 patients and signal averaged ECG in 44 patients for late potential analysis. Sixty percent of patients in group 1 had more than 1 ventricluar extrasystole per hour, while this was in only 31 % of patients in group 2 (p<0.05). Furthermore, among patients in group 1, 44 % had more serious ventricular arrhythmias than grade I, whereas this was seen in 4 % of the patients in group 2 (p<0.01). In late potential analysis, significant difference existed between the two groups: filtered QRS in group 1, 115±13 msec versus 99±12 msec in group 2; LAS40 in group 1, 39±13 msec, versus 24±11 msec in group 2; RMS40 in group 1, 22±18 microvolt versus 37±19 in group 2; p<0.01, respectively. We conclude that LVH increases the frequency and severity of ventricular arrhytmias and also prolongs filtered QRS and LAS40 duration while decreasing RBS40 voltage.