Predictive value of non-invasive parameters in patients with left ventricular hypertrophy during a five-year follow-up period

Abstract

Introduction: Regardless of other known factors, left ventricular hypertrophy is considered to be a significant factor which correlates with the risk of cardiovascular complications. In practice, it is very important to predict the outcome for every patient at the beginning of the treatment. Objective: The aim of the study was to follow the predictive value of non-invasive parameters obtained at the beginning of the study in patients with essential arterial hypertension and left ventricular hypertrophy who were treated by regular therapy through a five year follow-up period. Methods: Ninety patients (average age 55) with essential hypertension and left ventricular hypertrophy were examined. All patients were studied at baseline after temporary discontinuation of previous antihypertensive therapy. The follow-up period started at the baseline examination and lasted for five years. Adverse cardiovascular events occurred in 15 (16.7%) patients. Results: Non-invasive parameters were tested by stepwise multiple regression analysis.Three examined parameters had predictive value: QTc interval dispersion (beta=0.325, p=0.001), septal wall thickness (beta=0.294, p=0.003) and low increase of the heart rate during exercise testing (beta=-0.202, p<0.04). For this model, adjusted R square=0.203; F384=8.406, p<0.0001. Conclusion: In spite of regular medical treatment, patients with larger QTc dispersion, greater septum thickness and lower increase of heart rate during exercise testing showed worse outcome through the follow-up period.These patients should be recognized as early as possible and treated more aggressively.