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

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; F3,84 = 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.