title: The assessment of relationship between left ventricular geometry and microvolt T-wave alternans in sustained hypertension.
abstract: OBJECTIVE
  Left ventricular (LV) hypertrophy (LVH) predicts increased mortality in part due to an elevated incidence of sudden cardiac death in hypertension. The aim of the present study was to investigate the relation of microvolt T-wave alternans (MTWA) with different LV geometric patterns in patient with sustained hypertension.
  
  
  METHODS
  This study consisted of 311 consecutive patients with sustained hypertension who were divided into four groups according to LV geometrical patterns. 90 patients were in the normal geometry group (NGG) [mean age 49.6 ± 7.8 years; 60 males (66.7%)], 99 patients were in the concentric remodeling group (CRG) [mean age 50.9 ± 6.6 years; 50 males (50.6%)], 63 patients were in the concentric hypertrophy group (CHG) [mean age 51.6 ± 7.3 years; 32 males (50.7%)] and 58 patients were in the eccentric hypertrophy group (EHG) [mean age 51.6 ± 9.0 years; 30 males (51.7%)]. Physical examination, laboratory work-up, office blood pressure measurement, transthoracic echocardiography and MTWA measurements were performed on all participants.
  
  
  RESULTS
  MTWA positivity was significantly higher in EHG and CHG as compared to CRG and NGG (p < 0.001). Left ventricle mass index (LVMI), LV end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), interventricular septum diameter (IVSd), posterior wall diameter (PWd) and office systolic blood pressure (SBP) were found to be significantly positively correlated with MTWA (all p-values < 0.05).
  
  
  CONCLUSIONS
  We demonstrated that increased LVMI is associated with an elevated MTWA positivity in sustained hypertensives. Moreover, clinically significant LV geometric patterns including both concentric and eccentric hypertrophy are related with a raised MTWA positivity, which may lead to particular predilection to life-threatening ventricular arrhythmias and sudden cardiac death in sustained hypertension.
authors.affiliation: Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology , Istanbul , Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Surgit
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erturk
authors.forename: Ali
authors.initials: A
authors.lastname: Buturak
authors.forename: Ozgur
authors.initials: O
authors.lastname: Akgul
authors.forename: Hamdi
authors.initials: H
authors.lastname: Pusuroglu
authors.forename: Huseyin Altug
authors.initials: HA
authors.lastname: Cakmak
authors.forename: Serkan
authors.initials: S
authors.lastname: Yazan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gul
authors.forename: Emre
authors.initials: E
authors.lastname: Akkaya
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Eksik
mesh_terms: D000328:Adult; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged
keywords: Concentric hypertrophy; eccentric hypertrophy; left ventricular geometry; microvolt t-wave alternans; sustained hypertension