Relationship between hypertensive left ventricular hypertrophy, neurohormonal factors and ventricular arrhythmias in very old patients.
OBJECTIVE
To study the relationship between hypertensive left ventricular hypertrophy (LVH) in very old patients (> or = 80 years) with neuro-hormonal factors and ventricular arrhythmias.


METHODS
Heart rate variation, plasma renin (Ren), angiotensin-II (AT-II), aldosterone (Ald), insulin (Ins), Holter and ambulatory blood pressure monitoring were measured in 60 cases (> or = 80 years) which were divided into 2 groups: 30 with primary hypertension accompanied LVH in very old patients (group A); 30 with simple primary hypertension (group B).


RESULTS
There was no significant difference of AT-II and Ren between group A and B (P > 0.05); Ins and Ald values in group A was much higher than in group B (P all < 0.01); the data of heart rate variability, including very low frequency (VLF) and low frequency (LF) and LF/HF (high frequency) in group A were significantly higher than in group B (P < 0.01, < 0.05, < 0.05, respectively); incidence of premature ventricular contractions (PVC) and myocardial ischaemia in group A were higher than in group B patients.


CONCLUSIONS
Sympathetic nerve excitability in group A was greatly increased; hypertensive LVH was closely associated with Ald and Ins level, but not with AT-II and Ren. Group A is characterized by a significantly greater frequency of premature ventricular contractions and ischaemia.
Guo
Hangyuan
H
Department of Cardiology, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hangzhou 310016, China. ghangyuan@hotmail.com
Cheng
Jianfeng
J
Lee
Jong-Dae
JD
Ueda
Takanori
T
Shan
Jiang
J
Wang
Jian'an
J
D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D008297:Male; D018377:Neurotransmitter Agents / Q000097:blood*; D012083:Renin / Q000097:blood
D015415:Biomarkers; D007328:Insulin; D018377:Neurotransmitter Agents; D000804:Angiotensin II; D000450:Aldosterone; D012083:Renin