HYPERTENSIVE LEFT-VENTRICULAR HYPERTROPHY AND VENTRICULAR LATE POTENTIALS

Ventricular arrhythmias occur with increased frequency in hypertensive patients with left ventricular hypertrophy (LVH). The aim of this work is to study the incidence of ventricular late potentials (LP) and their relation to ventricular arrhythmias in 148 hypertensive patients, 87 men and 55 women, without evidence of a coronaropathy. For each patient we carried out a signal-averaged electrocardiography, an echocardiogram to determine the LV mass index (LVMI) and the LV end-diastolic dimension (EDD), and 24 hours Holter monitoring to record ventricular arrhythmias filed according to Lown's classification. LP were considered present if the root-mean-square voltage during the last 40 ms of the QRS was : < 20 uV in absence of bundle branch block, or less-than-or-equal-to 17 uV in presence of bundle branch block. [GRAPHICS] The frequence of LP appears exceptional in hypertensive patients without LVH (5 %) and remains uncommon in patients with concentric LVH (13 %). The incidence of LP is only frequent at the end stage of hypertensive cardiopathy with excentric LVH (48 %). The severity of ventricular arrhythmias is only correlated to the presence of LP in patients with concentric LVH (p < 0.02).