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. 2017 Dec;14(12):717-724.
doi: 10.11909/j.issn.1671-5411.2017.12.001.

Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension

Ana Ciobanu  1 , Gary Tse  2 , Tong Liu  3 , Maria V Deaconu  1 , Gabriela S Gheorghe  1 , Adriana M Ilieşiu  1 , Ioan T Nanea  1
Affiliations

Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension

Ana Ciobanu et al. J Geriatr Cardiol. 2017 Dec.

Abstract

Objective: To examine the relationship between Tpeak- Tend interval (Tpe) and Tpe/QT ratio with occurrence of ventricular premature beats (VPBs) and left ventricular remodeling in hypertension.

Methods: A total of 52 patients with mild to moderate essential hypertension were included, undergoing echocardiography and 24-hours Holter monitoring. Ventricular remodeling was assessed by left ventricular mass index (LVMI) using the Devereux formula and diastolic function by transmitral E and A wave velocities and E/A ratio. Tpe was measured in the precordial leads. The end of the T wave was set by the method of the tangent to the steepest descending slope of the T wave.

Results: Tpe and Tpe/QT in leads V2 (r = 0.33, P = 0.01; r = 0.27, P = 0.04 respectively) and V3 (r = 0.40, P = 0.002; r = 0.40, P = 0.003, respectively) correlated significantly with LVMI. A significant inverse relationship was observed between E/A ratio and QT (r = -0.33, P = 0.01), Tpe in V3 (r = -0.39, P = 0.003) and Tpe/QT in V3 (r = -0.31, P = 0.02). Tpe in V3, V5, mean Tpe and maximum Tpe with cut-off values of 60 ms, 59 ms, 62 ms and 71 ms, respectively, associated with the occurrence of ventricular premature beats.

Conclusions: The repolarization parameters Tpe interval and Tpe/QT ratio correlate with LVMI and indices of left ventricular diastolic function and show better predictive values than traditional parameters such as QT interval and QT dispersion. Lead V3 is the best lead for measuring Tpe and Tpe/QT. These ECG indices can therefore be used in clinical practice to monitor LV remodeling and predict occurrence of VPBs.

Keywords: Hypertension; Repolarization; Tpeak-Tend; Ventricular remodeling.

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Figures

Figure 1.
Figure 1.. Measurement of Tpe interval.
The end of the T wave was measured by convention using the method of the tangent to the steepest slope of the descending portion of the T wave. Tpe: Tpeak - Tend.
Figure 2.
Figure 2.. Scatterplot of Tpe in leads V2 and V3 against LVMI.
There were significant correlations between Tpe measured in leads V2 and V3 with LVMI. LVMI: left ventricular mass index; Tpe: Tpeak - Tend.
Figure 3.
Figure 3.. Scatterplot of Tpe/QT in leads V2 and V3 against LVMI.
There were significant correlations between Tpe/QT measured in leads V2 and V3 with LVMI. LVMI: left ventricular mass index; Tpe: Tpeak - Tend.
Figure 4.
Figure 4.. Scatterplot of Tpe in lead V3 against E/A ratio.
There was a significant correlation between Tpe measured in V3 and E/A ratio. Tpe: Tpeak - Tend.
Figure 5.
Figure 5.. Scatterplot of Tpe/QT in lead V3 against E/A ratio.
There was a significant correlation between Tpe/QT measured in V3 and E/A ratio. Tpe: Tpeak - Tend.
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