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: University of Helsinki, HUS Internal Medicine and Rehabilitation
University of Helsinki, HUS Internal Medicine and Rehabilitation
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, HUS Internal Medicine and Rehabilitation
University of Helsinki, Kardiologian yksikkö
Date: 2020-03-24
Language: eng
Number of pages: 13
Belongs to series: PLoS One
ISSN: 1932-6203
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
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