Features of cardiac rhythm disorders and conduction disturbances in patients with arterial hypertension

Authors

  • A. M. Vasylenko Dnipropetrovsk Medical Academy of Health Ministry of Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2017.2.95557

Keywords:

hypertension, arrhythmia, cardiac complexes, premature, atrial fibrillation

Abstract

Objective – to study features of cardiac rhythm disorders and conduction disturbances in patients with arterial hypertension.

Methods of the study. Under our observation there were 110 patients with first-third degree hypertension stage II, aged 38 to 72 years (mean age – 50.63 ± 1.34 years). The gender distribution of patients was as follows: 61 female (55 %) and 49 male patients (45 %). The control group comprised 30 healthy individuals, of whom 13 were male and 17 female (43 % and 57 % respectively) and whose mean age was 49.75 ± 1.83 years. Cardiac arrhythmias and conduction disorders were detected by means of Holter ECG. Statistical analysis was carried out on a personal computer, using such programs as Excel-7.0 (Microsoft Corp., USA) and «Statistica® for Windows 6.0» (StatSoft Inc., License number AXXR712D833214FAN5) through parametric and nonparametric methods.

Results. Cardiac arrhythmias were found in 71 (65 %) patients with arterial hypertension and were characterized by the presence of supraventricular extrasystole in 43 (39 %) patients and paroxysmal atrial fibrillation in 10 (9 %) patients. Ventricular extrasystole and episodes of unstable ventricular tachycardia were diagnosed in 13 (12 %) and 5 (5 %) patients, respectively. In hypertensive patients supraventricular arrhythmias were detected in 2.8 times more likely (p < 0.01), and single ventricular premature beats – 6.2 times more likely (p <0.01) than the control group. It was found that in patients with moderate and severe hypertension observed a statistically significant increase in the number of single supraventricular and ventricular premature beats – 21.5 % (p < 0.05) and 29.6 % (p < 0.05) respectively, compared with the subgroup of mild hypertension.

Conclusions. Patients with arterial hypertension are characterized by a wide range of supraventricular and ventricular arrhythmias, namely extrasystole, atrial fibrillation, ventricular tachycardia.

References

Kovalenko, V. M., & Kornatskyi, V. M. (Eds.) (2016). Problemy zdorov’ia i medychnoi dopomohy ta model pokrashchennia v suchasnykh umovakh: posibnyk [Problems of health and medical care and improved model in modern conditions]. Kyiv: Gordon. [in Ukrainian]

Kovalenko, V. M., & Kornatskyi, V. M. (Eds.) (2013). Rehionalni medyko-sotsialni problemy khvorob systemy krovoobihu : analitychno-statystychnyi posibnyk [Regional medical and social problems of cardiovascular diseases: analytical and statistical manual]. Kyiv. [in Ukrainian]

Yiu, K. H., & Tse, H. F. (2008). Hypertension and cardiac arrhythmias: a review of the epidemiology, pathophysiology and clinical implications. J. Hum. Hypertens, 22(6), 380–388. doi: 10.1038/jhh.2008.10.

Vester, E. G. (2008). Arterial hypertension and cardiac arrhythmias. Dtsch. Med. Wochenschr, 133(8), 261–265.

Kondratiuk, V. Ye. (2009). Statevi vidminnosti strukturno–funktsionalnoho stanu sertsia ta sudyn, systemnoi ta intrakardialnoi hemodynamiky, bioelektrychnoi aktyvnosti i homohennosti miokarda u patsiientiv z hipertonichnoiu khvoroboiu [Sex differences in structural and functional condition of the heart and vascular system and intracardial hemodynamics and bioelectric activity of homogeneity infarction in hypertensive patients]. Krovoobih ta hemostaz, 1–2, 54–61. [in Ukrainian]

Cosio, F. G. (2007). A peek at AF myocardial substrate through the signal-averaged ECG? J. Cardiovasc. Electrophysiol., 18(6), 939–941. doi: 10.1111/j.1540-8167.2007.00920.x.

Lau, D. H., Mackenzie, L., Kelly, D. J., Psaltis, P. J., Worthington, M., Rajendram, A., et al. (2010). Short term hypertension is associated with the development of atrial fibrillation substrate: A study in an ovine hypertensive model. Heart Rhythm, 7, 396–404. doi: 10.1016/j.hrthm.2009.11.031.

Kistler, P. M., Sanders, P., Dodic, M., Spence, S. J., Samuel, C. S., Zhao, C., et al. (2006). Atrial electrical and structural abnormalities in an ovine model of chronic blood pressure elevation after prenatal corticosteroid exposure: implications for development of atrial fibrillation. Eur. Heart J., 27, 3045–3056. doi: 10.1093/eurheartj/ehl360.

Lau, D. H., Mackenzie, L., Kelly, D. J., Psaltis, P. J., Brooks, A. G., Worthington, M., et al. (2010). Hypertension and atrial fibrillation: evidence of progressive atrial remodeling with electrostructural correlate in a conscious chronically instrumented ovine model. Heart Rhythm, 7, 1282–1290. doi: 10.1016/j.hrthm.2010.05.010.

Lader, J. M., Vasquez, C., Bao, L., Maass, K., Qu, J., Kefalogianni, E., et al. (2011). Remodeling of atrial ATP-sensitive K(+) channels in a model of salt-induced elevated blood pressure. Am. J. Physiol. Heart Circ. Physiol., 301, 964–974. doi: 10.1152/ajpheart.00410.2011.

Aidietis, A. Laucevicius, A., & Marinscis, G. (2007). Hypertension and cardiac arrhythmias. Curr. Pharm. Des., 13(25), 2545–2555.

Choisy, S. C., Arberry, L. A., Hancox, J. C., & James, A. F. (2007). Increased susceptibility to atrial tachyarrhythmia in spontaneously hypertensive rat hearts. Hypertension, 49, 498–505. doi: 10.1161/01.HYP.0000257123.95372.ab.

(2010). 2011 ACCF / AHA / HRS focused update on the management of patients with atrial fibrillation (updating the 2006 Guideline) J. Am. Coll. Cardiol., 57(2), 223–242.

Mitchell, G. F., Vasan, R. S., Keyes, M. J., Parise, H., Wang, T. J., Larson, M. G., et al. (2007). Pulse pressure and risk of new-onset atrial fibrillation. J. Am. Med. Assoc., 297(7), 709–715. doi: 10.1001/jama.297.7.709.

Bobrov, V. A., & Davydova, I. V. (2009). E´kstrasistoliya: klinicheskoe znachenie, diagnostika i lechenie [Extrasystole: clinical significance, diagnosis and treatment]. Novosti mediciny i farmacii, 22(302), 12–16. [in Ukrainian]

Kume, O., Takahashi, N., Wakisaka, O., Nagano-Torigoe, Y., Teshima, Y., Nakagawa, M., et al. (2011). Pioglitazone attenuates inflammatory atrial fibrosis and vulnerability to atrial fibrillation induced by pressure overload in rats. Heart Rhythm, 8, 278–285. doi: 10.1016/j.hrthm.2010.10.029.

Friedrichs, K., Klinke, A., & Baldus, S. (2011). Inflammatory pathways underlying atrial fibrillation. Trends Mol. Med., 17, 556–563. doi: 10.1016/j.molmed.2011.05.007.

Uhm, J. S., Shim, J., & Wi, J. (2014). First-degree atrioventricular block is associated with advanced atrioventricular block, atrial fibrillation and left ventricular dysfunction in patients with hypertension. J. Hypertens., 32(5), 1115–1120. doi: 10.1097/HJH.0000000000000113.

Iskenderov, B. G., Vakina, T. N., & Shibayeva, Т. М. (2004) Chastota i kharakter narushenij ritma i provodimosti serdca u bol'nykh s razlichnymi kliniko-patogeneticheskimi variantami gipertonicheskoj bolezni [The incidence and pattern of cardiac rhythm and conduction disturbances in patients with different clinical and pathogenetic types of hypertensive disease]. Klinicheskaya medicina, 82(8), 21–24. [in Russian]

Conen, D., Adam, M., Roche, F., Barthelemy, J. C., Felber Dietrich, D., Imboden, M., et al. (2012). Premature atrial contractions in the general population: frequency and risk factors. Circulation, 126(19), 2302–2308. doi: 10.1161/CIRCULATIONAHA.112.112300.

Ofoma, U., He, F., Shaffer, M. L., Naccarelli, G. V., & Liao, D. (2012). Premature cardiac contractions and risk of incident ischemic stroke. J. Am. Heart Assoc., 1(5), e002519. doi: 10.1161/JAHA.112.002519.

Golicyn, S. P. (2008). Grani pol'zy i riska v lechenii zheludochkovykh narushenij ritma serdca [Facets of the benefits and risks in the treatment of ventricular cardiac arrhythmias]. Vestnik aritmologii, 21, 30–42. [in Russian]

Streitner, F., Kuschyk, J., Veltmann, C., Brueckmann, M., Streitner, I., Brade, J., et al. (2007). Prospective study of interleukin-6 and the risk of malignant ventricular tachyarrhythmia in ICD-recipients. A pilot study. Cytokine, 40(1), 30–34.

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1.
Vasylenko AM. Features of cardiac rhythm disorders and conduction disturbances in patients with arterial hypertension. Zaporozhye Medical Journal [Internet]. 2017Mar.14 [cited 2024Dec.23];19(2). Available from: http://zmj.zsmu.edu.ua/article/view/95557

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Original research