Prognostic role of Sokolow-Lyon criterion in further development of the left ventricular concentric hypertrophy in adolescents with arterial hypertension
DOI:
https://doi.org/10.14739/2310-1210.2017.1.91605Keywords:
Left Ventricular Hypertrophy, High Blood Pressure, Еlectrocardiography, Sensitivity, Specificity, АdolescentsAbstract
Objective – to determine the possibility of Sokolow-Lyon criterion for forecast of the concentric Left Ventricular Hypertrophy (LVH) development in young hypertensive patients. The investigation has been organized as a prospective support of teenagers aged 16-17 yr within 3 years.
Materials and Methods. Methods of the study were multiple office blood pressure measurements, daily blood pressure monitoring with electronic device, ECG and ultrasound. 47 males and females teens with firstly diagnosed primary arterial hypertension not treated before were enrolled. Primary labile hypertension diagnosed in 10 males and 11 females and 18 males and 8 females had stable hypertension. For all patients the electrocardiographic study was performed. The positive Sokolow-Lyon criterion was considered as a sum in height of S1 and R5 or R6 waves in standard chest leads excessed34 mm. Watching teens conducted during 3 years.
Results. Sokolow-Lyon criterion >34 mm (3.4 mV) was identified as positive in 8 males with a stable and 6 with a labile hypertension, also it was the same in 6 females, all of them had stable hypertension. Morphological and functional left ventricular parameters in patients were minimal and appeared only as a mild thickening of the myocardial wall of the left ventricle. Only one girl who was positive by Sokolow-Lyon criterion had LVH and was excluded from the study. Repeated clinical and instrumental examination was carried out in 46 persons over 3 years to the age of 21 years. New ultrasound investigation showed the left ventricular hypertrophy development in 18 young men and 5 women with stable hypertension. The odds ratio for the development of concentric hypertrophy of the left ventricle during 3 years of the young people with diagnosed in adolescence index Sokolow-Lyon >34 mm was 8.906 with a 95% confidence interval 2.24-35.33 (p < 0.05). The sensitivity of Sokolow-Lyon criterion in predicting of the left ventricular hypertrophy during 3 years was 82.6 %, specificity 65.2 %, accuracy 74.0 %.
Conclusions. The revealing of the positive Sokolow-Lyon criterion in adolescents with primary arterial hypertension may precede the development of ultrasound signs of the left ventricular hypertrophy and that should be used as an additional indication of the risk stratification of disease progression during adolescence.
References
Mancia, G., De Backer, G., Dominiczak, A. et al. (2007). Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens, 25, 1105–1187.
Radchenko, G. D., Torbas, O. O., & Sirenko, Yu. M. (2015). Izolovana systolichna arterialna hipertenziia u molodykh: chy vsikh maiemo likuvaty? [Isolated systolic hypertension in young people: do we have to treat all of them?]. Ukrainskyi kardiolohichnyi zhurnal, 2, 17–25. [in Ukranian].
Maidannyk, V. H., Koreniev, M. M., Khaitovych, M. V., & Bohmat, L. F. (2006). Diahnostyka ta klasyfikatsiia pervynnoi arterialnoi hipertenzii u ditei [Diagnosis and classification of primary hypertension in children]. Pediatriia, akusherstvo ta hinekolohiia, 6, 3–10. [in Ukranian].
(2011). Rekomendatsii Ukrainskoi asotsiatsii kardiolohiv z profilaktyky ta likuvannia arterialnoi hipertenzii [Recommendations of Ukrainian Association of Cardiology on prevention and treatment of hypertension]. Posibnyk do Natsionalnoi prohramy profilaktyky ta likuvannia arterialnoi hipertenzii. Kyiv. Retrieved from http://www.webcardio.org. [in Ukranian].
Korenev, M. M., Bogmat, L. F., & Nosova, Ye. M. (2010). Arterial´naya gipertenziya podrostkovogo vozrasta: rasprostranyonnost’, mekhanizmy formirovaniya, podhody k lecheniyu [Hypertension prevalence of adolescent age: the formative mechanisms, approaches for treatment]. Pediatriya, akusherstvo ta ginekologiya, 72(4), 68–69. [in Ukranian].
Ivanko, O. H., Mykhaliuk, Ye. L., Pidkova, V. Ya., Malakhova, S. M., Nedelska, Ye. V., & Selina, Yu. V. (2015). Fizychna reabilitatsiia pidlitkiv 16–17 rokiv iz arterialnoiu hipertenziieiu z vykorystanniam velotrenazheru v umovakh navchalnoho zakladu [Physical rehabilitation of adolescents 16-17 years of hypertension using an exercise bike in the conditions of the institution]. Dytiachyi likar, 40–41(3–4), 9–22. [in Ukranian].
Antikainen, R. L., Grodzicki, T., Beevers, D. G., Webster, J., Jokelainen, J. J., & Bulpitt, C. J. (2009). Left ventricular hypertrophy by Sokolow-Lyon voltage criterion predicts mortality in overweight hypertensive subjects. J Hum Hypertens, 23(1), 20–6. doi: 10.1038/jhh.2008.102.
Preobrazhensky, D. V., Sidorenko, B. A., Alekhin, M. N., Batyraliev, T. A., & Stetsenko, T. M. (2003). Gipertrophiya levogo zheludochka pri gipertonicheskoj bolezni. Chast´ 1: Kriterii diagnostiki gipertrophii levogo zheludochka i eyo rasprostranenie [Left Ventricular Hypertrophy in Hypertension. Part I. Criteria of Diagnosis and Prevalence]. Kardiologiya, 10, 99–104. [in Russian].
Tereshchenko, L. G., McNitt, S., Han, L., Berger, R. D., & Zareba, W. (2012). ECG Marker of Adverse Electrical Remodeling Post-Myocardial Infarction Predicts Outcomes in MADIT II Study. European Heart Journal, (7). e51812. doi: 10.1371/journal.pone.0051812.
Yakovenko, E. I. (2009). ECG-diagnostika gipertrophii levogo zheludochka [ECG diagnostics of left ventricular hypertrophy]. Rossijskij kardiologicheskij zhurnal, 5(79), 79–83. [in Russian].
Kamenshchyk, A. V., Ivanko, O. G., & Fedchenko, A. V. (2015) Nuklearnyi factor aktyvovanykh T-klityn (NFATC) yak mozhlyvyi diahnostychnyi i prohnostychnyi marker pry klapannykh vrodzhenykh vadakh sertsiya ta hipertrofii miokarda [Nuclear factor of activated T-cells (NFATC) as a possible diagnostic and prognostic marker in congenital valvular diseases and myocardial hypertrophy]. Pathologia, 1, 4–7. [in Ukranian]. doi: http://dx.doi.org/10.14739/2310-1237.2015.1.42815.
Kamenshchyk, A. V., Kamyshny, O. M., & Ivanko, O. G. (2016). Ekspresiia heniv nuklearnoho faktora aktyvovanykh T-klityn u ditei z dvostulkovym aortalnym klapanom sertsia [Gene expression of nuclear factor of activated T-cells in children with bicuspid aortic valve]. Medychni perspektyvy, 21(3), 29–33. [in Ukranian].
Feigenbaum, H., Armstrong, W. F., & Ryan, T. (2005) Feigenbaum's Echocardiography. Philadelphia. Lippincott: Williams & Wilkins.
Fedotova, A. G., Astratenkova, I. V., Linde, E. V., Orjonikidze, Z. Y., & Akhmetov, I. I. (2009). Kliniko-heneticheskie aspekty formirovania "patolohicheskoho sportivnoho serdtsa" y vusokokvalifitsirovannykh atletov [Clinical and genetic aspects for «pathologic sport heart» pathogenesis in elite athletes]. Vestnik sportivnoj nayki, 2, 32–37. [in Russian].
Linde, E. V., Akhmetov, I. I., Ordzhonikidze, Z. G., Astratenkova, I. V., & Fedotov, A. G. (2009). Vliyanie polimorfizmov genov ACE, РРАRA, PPARD i NFATC4 na kliniko-funkcional´nye kharakteristiki "sportivnogo serdca" [Influence of polymorphisms of genes ACE, РРАRA, PPARD and NFATC4 on the clinical-functional characteristics of the "heart strain"]. Mezhdunarodnyj zhurnal intervencionnoj kardioangiologii, 17, 50–56. [in Russian].
Teregulov, Yu. E, Teregulova, E. T., Mayanskaya, S. D., & Latipova, Z. K. (2014). Remodelirovanie levogo zheludochka: geometricheskie i e´lektrokardiograficheskie sopostavleniya [Remodeling of the left ventricle: geometrical and electrocardiographic comparisons]. Prakticheskaya medicina, 3(79), 149–154. [in Russian].
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