Effect of four classes of antihypertensive drugs on cardiac repolarization heterogeneity: A double-blind rotational study

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Sánez Tähtisalo , H , Hiltunen , T P , Kenttä , T , Junttila , J , Oikarinen , L , Virolainen , J , Kontula , K K & Porthan , K 2020 , ' Effect of four classes of antihypertensive drugs on cardiac repolarization heterogeneity: A double-blind rotational study ' , PLoS One , vol. 15 , no. 3 , 0230655 . https://doi.org/10.1371/journal.pone.0230655

Title: Effect of four classes of antihypertensive drugs on cardiac repolarization heterogeneity: A double-blind rotational study
Author: Sánez Tähtisalo, Heini; Hiltunen, Timo P.; Kenttä, Tuomas; Junttila, Juhani; Oikarinen, Lasse; Virolainen, Juha; Kontula, Kimmo K.; Porthan, Kimmo
Contributor organization: HUS Internal Medicine and Rehabilitation
Department of Medicine
University of Helsinki
Helsinki University Hospital Area
CAMM - Research Program for Clinical and Molecular Metabolism
Research Programs Unit
Faculty of Medicine
HUS Heart and Lung Center
Kardiologian yksikkö
Clinicum
Date: 2020-03-24
Language: eng
Number of pages: 13
Belongs to series: PLoS One
ISSN: 1932-6203
DOI: https://doi.org/10.1371/journal.pone.0230655
URI: http://hdl.handle.net/10138/316154
Abstract: Background T-wave area dispersion (TW-Ad) is a novel electrocardiographic (ECG) repolarization marker associated with sudden cardiac death. However, limited data is available on the clinical correlates of TW-Ad. In addition, there are no previous studies on cardiovascular drug effects on TW-Ad. In this study, we examined the relation between TW-Ad and left ventricular mass. We also studied the effects of four commonly used antihypertensive drugs on TW-Ad. Methods A total of 242 moderately hypertensive males (age, 51±6 years; office systolic/diastolic blood pressure during placebo, 153±14/100±8 mmHg), participating in the GENRES study, were included. Left ventricular mass index was determined by transthoracic echocardiography. Antihypertensive four-week monotherapies (a diuretic, a beta-blocker, a calcium channel blocker, and an angiotensin receptor antagonist) were administered in a randomized rotational fashion. Four-week placebo periods preceded all monotherapies. The average value of measurements (over 1700 ECGs in total) from all available placebo periods served as a reference to which measurements during each drug period were compared. Results Lower, i.e. risk-associated TW-Ad values correlated with a higher left ventricular mass index (r = −0.14, p = 0.03). Bisoprolol, a beta-blocker, elicited a positive change in TW-Ad (p = 1.9×10−5), but the three other drugs had no significant effect on TW-Ad. Conclusions Our results show that TW-Ad is correlated with left ventricular mass and can be modified favorably by the use of bisoprolol, although demonstration of any effects on clinical endpoints requires long-term prospective studies. Altogether, our results suggest that TW-Ad is an ECG repolarization measure of left ventricular arrhythmogenic substrate.
Subject: 3121 General medicine, internal medicine and other clinical medicine
LEFT-VENTRICULAR HYPERTROPHY
T-WAVE MORPHOLOGY
QT INTERVAL
INTERLEAD HETEROGENEITY
PREDICTIVE-VALUE
INCREASED RISK
ALL-CAUSE
DEATH
POPULATION
HYPERTENSION
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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