Influence of the Type and Degree of Left Ventricular Hypertrophy on the Prevalence of Ventricular Arrhythmias in Patients with Hypertensive Heart Disease

Purpose: To investigate the correlation between the prevalence of ventricular arrhythmias (VA) and the type and degree of left ventricular hypertrophy (LVH) in hypertensive patients using exercise testing and Holter monitoring. Patients and Methods: A total of 192 patients (87 men and 105 women) without coronary disease were divided into three groups according to type of LVH (concentric, eccentric, and asymmetric) and three subgroups in relation to the degree of hypertrophy (mild, moderate, and severe). In all subjects blood pressure was measured, electrocardiographic and echocardiographic data obtained and the prevalence of VA determined by Holter monitoring and bicycle ergometry. Results: The most frequent LVH type was the concentric (63%), followed by eccentric (28%) and asymmetric (9%). Severe LVH was found in 10% of patients. Complex VA during Holter monitoring were identified in > 40% of patients. During the stress test this percentage increased by additional 7.4%. There was no statistically significant difference between groups in frequency of simple (p = 0.757) and complex (p = 0.657, p = 0.819, p = 0.617, for polytopic, pairs and ventricular tachycardia, respectively) VA. Increased prevalence of VA was found for the moderate and severe degree in all types. In the concentric type the difference was statistically significant for simple VA (p = 0.042). Conclusion: There was no correlation between type of LVH and prevalence of VA. The severity of hypertrophy contributes more to a greater prevalence of VA than the LVH pattern. The combination of severe degree and concentric type carries the greatest cardiovascular risk.