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. 2003 Jan;8(1):47-54.
doi: 10.1046/j.1542-474x.2003.08108.x.

Long-term improvement of QT dispersion is unaffected by short-term changes in blood pressure during treatment of systemic hypertension with enalapril

Francisco Javier García Seara  1 , José Ramón González Juanatey, José Luis Martínez Sande, Pedro Rigueiro Veloso, Antonio Pose Reino, Alfonso Varela Román, José Cabezas Cerrato, Miguel Gil de la Peña
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Long-term improvement of QT dispersion is unaffected by short-term changes in blood pressure during treatment of systemic hypertension with enalapril

Francisco Javier García Seara et al. Ann Noninvasive Electrocardiol. 2003 Jan.

Abstract

Background: We report the reduction of QT and QTc dispersion in patients treated for 7 years with enalapril for systemic hypertension with left ventricular (LV) hypertrophy. We assess the correlation between QT dispersion and LV mass during this period and at the end of an 8-week period of suspension of enalapril treatment after 5 years.

Methods: Twenty-four previously untreated patients with this condition took enalapril (20 mg twice daily) for 7 years, except during an 8-week period following 5-year follow-up. Cardiovascular parameters were determined by two-dimensional guided M-mode echocardiography, and QT interval was measured, in a pretreatment placebo phase, 8 weeks and 1, 3, 5, and 7 years after the start of the therapy, at the end of the 8-week suspension effected after 5 years, and 8 weeks after the end of the suspension.

Results: Therapy rapidly reduced blood pressure (BP) from 156/105 mmHg to normal values: 134/84 mmHg after 8 weeks' treatment, 130-84 mmHg at 7-year follow-up (P < 0.001 with respect to the placebo phase). LV mass index decreased progressively until at 5-year follow-up the reduction had reached 39% (P < 0.001), after which neither LV mass nor any other structural parameter underwent any further significant change. During this time, QT dispersion (DeltaQT) and the dispersion of "corrected" QT (DeltaQTc) decreased significantly: DeltaQT (from 61 +/- 21 to 37 +/- 13 ms) and DeltaQTc (from 67 +/- 27 to 41 +/- 16 ms). After suspension of treatment for 8 weeks following 5-year follow-up, DeltaQT was 40 +/- 14 ms and DeltaQTc was 44 +/- 17 ms; there were no significant changes either in DeltaQT and DeltaQTc or LV hypertrophy although BP had returned to pretreatment values (BP: 150 +/- 16; 101 +/- 10 mmHg).

Conclusions: Long-term enalapril treatment of hypertensive patients with LV hypertrophy induces marked regression of LV mass and improvement of QT dispersion. These improvements occur on a longer timescale than improvement in BP, and are not affected by transient changes in BP values.

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Figures

Figure 1
Figure 1
BP during 7 years of enalapril treatment. Eight‐week suspension of treatment after 5 years raised BP to pretreatment values.
Figure 2
Figure 2
LVMI during 7 years of enalapril treatment. The 8‐week suspension after 5‐year follow‐up had no significant effect.
Figure 3
Figure 3
ΔQT and ΔQTc during 7 years of enalapril treatment. They were not affected by the 8‐week suspension of treatment after 5 years.
Figure 4
Figure 4
LVMI regression (%) and ΔQTc reduction (%) during 7 years of enalapril treatment.
See this image and copyright information in PMC

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References

    1. Zabel M, Portnoy S, Franz M. Electrocardiographic indices of dispersion of ventricular repolarization: An isolated heart validation study. J Am Coll Cardiol 1995;25: 746–752. - PubMed
    1. Statters DJ, Malik M, Ward DE, et al. QT dispersion: Problems of methodology and clinical significance. J Cardiovasc Electrophysiol 1994;5: 672–685. - PubMed
    1. Priori SG, Napolitano C, Diehl L, et al. Dispersion of the QT interval: A marker of therapeutic efficacy in the idiopathic long QT syndrome. Circulation 1994;89: 1681–1689. - PubMed
    1. Glancy JM, Garrant CJ, Woods KL, et al. QT dispersion and mortality after myocardial infarction. Lancet 1995;354: 945–948. - PubMed
    1. Perkiomaki JS, Koistinen J, Yli‐Mayri S, et al. Dispersion of QT interval in patients with and without susceptibility to ventricular tachyarrhythmias after previous myocardial infarction. J Am Coll Cardiol 1995;26: 174–179. - PubMed

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