Araştırma Makalesi
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Evaluation of the Relationship Between Masked Hypertension and P Wave Dispersion

Yıl 2023, Cilt: 20 Sayı: 1, 25 - 30, 27.04.2023

Serhat Çalışkan Mehmet Atay Şenel Altun

https://doi.org/10.35440/hutfd.1127459

Öz

Background: Atrial fibrillation is the most common arrhythmia in daily practice. Hypertension is an independent risk factor for atrial fibrillation. P wave dispersion is one of the accepted non-invasive parameters to predict atrial fibrillation. In our study, we aimed to examine whether the P wave durations of the patients followed up with the diagnosis of masked hypertension differed compared to the control group.
Materials and Methods: A total of 82 people were included in the study as 40 patients with masked hypertension who were similar in terms of age and gender, and 42 as the control group. The laboratory data and electrocardiography (ECG) parameters of the individuals participating in the study were analyzed retrospectively. P wave durations were calculated from the ECG recordings of all participants.
Results: P wave dispersion time (44.88±5.63 ms and 38.38±6.21 ms) and P maximum duration (127.28±4.19 ms and 121.38±6.05 ms) in the masked hypertension group significantly higher than the group (p<0.001). Body mass index values of individuals diagnosed with masked hypertension (26.28±2.23 and 24.9±2.89 p<0.05) were found to be statistically higher than the control group. No significant difference was found between the laboratory data of the patients.
Conclusion: P wave dispersion and P max duration are prolonged in patients with masked hypertension and these parameters can be used to predict arrhythmia.

Anahtar Kelimeler

Masked Hypertension Arrhythmia P wave dispersion

Kaynakça

  • 1) Vas LE, Oren A, Uiterwaal C, Gorissen W.H.M, Diederick E, Grobbee Bots M.L. Adolescent Blood Pressure And Blood Pressure Tracking İnto Young Adulthood Are Related To Subclinical Atherosclerosis: The Atherosclerosis Risk in Young Adults (Arya) Study. American Journal of Hypertension, 2003; 16:549-55.
  • 2) Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 2018 Oct;36(10):1953-2041.
  • 3) Hypertension EETFftMoA. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens. 2013;31(10):1925-38.
  • 4) Bobrie G, Clerson P, Menard J, Postel-Vinay N, Chatellier G, Plouin, PF, 2008. Masked hypertension: A systematic review, J Hypertens, 26(9), 1715-1725.
  • 5) Bjorklund K, Lind L, Zethelius B, et. al. İsolated ambulatuary hypertension predicts cardiovascular morbidity in elderly men. Circulation 2003;107(9):1297-1302.
  • 6) Verdecchia P, Schilatti G, Borgioni C, et al. Cigarette smoking, ambulatory blood pressure and cardiac hypertrophy in essential hypertension. J Hypertens. 1995;13:1209– 1215.
  • 7) Levy S. Factors predisposing to the development of atrial fibrillation. PACE 1997;20:2670-74.
  • 8) Tyoshima H, Park YD, Ishikawa Y, et al: Effect of ventricular hypertrophy on conduction velocity of activation trent in the ventricular myocardium. Am 1 Cardiol 1982;49: 1938-1945.
  • 9) Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis and redisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998;82:2N–9N.
  • 10) Dilaveris PE: P wave dispersion and atrial arrhytmias. Türk Aritmi Pacemaker ve Elektrofizyoloji Dergisi 4: 187-96, 2006.
  • 11) Dilaveris PE, Gialafos EJ, Sideris SK, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998; 135 (5): 733-8.
  • 12) Dilaveris PE, Gialafos EJ, Chrissos D, Andrikopoulos GK, Richter DJ, Lazaki E, Gialafos JE. Detection of hypertensive patients at risk for paroxysmal atrial fibrillation during sinus rhythm by computer-assisted P wave analysis. J Hypertens 1999; 17: 1463- 1470.
  • 13) Yilmaz R, Demirbag R P-wave dispersion in patients with stable coronary artery disease and its relationship with severity of the disease. Journal of Electrocardiology 2005:38;279–284.
  • 14) Turhan H, Yetkin E, Senen K, Yilmaz MB, Ileri M, Atak R, et al. Effects of percutaneous mitral balloon valvuloplasty on P-wave dispersion in patients with mitral stenosis. Am J Cardiol 2002;89:607-09.
  • 15) Turhan H, Yetkin E, Atak R, Altinok T, Senen K, Ileri M, et al. Increased P-wave duration and P-wave dispersion in patients with aortic stenosis. Ann Noninvasive Electrocardiol 2003;8:18.
  • 16) Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370-5.
  • 17) Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace 2010; 12(10): 1360-1420.
  • 18) P. S. Moran , C. Teljeur, P. Harrington, S. M. Smith, B. Smyth, J. Harbison, C. Normand ve M. Ryan, “Cost-Effectiveness of a National Opportunistic Screening Program for Atrial Fibrillation in Ireland”, Value in Health, c. 19, sayı 8, ss. 985– 995, 2016.
  • 19) Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365: 217–223.
  • 20) Ezzati M, Lopez AD, Rodgers A, Hoorn SV, Murray JL. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360: 1347–1360.
  • 21) Mattioli AV, Bonatti S, Monopoli D, Zennaro M, Mattioli G Left atrial remodelling after short duration atrial fibrillation in hypertrophic hearts. Heart. 2005;91(1):91-92.
  • 22) Calhoun DA, Bakir S, Oparil S. Etiology and pathogenesis of essential hypertension. Crawford MH, DiMarco JP. Cardiokogy. Mosby 2001 London pp. 3 1.1-3 1.10.
  • 23) Lammers WJ, Kirchhof C, Bonke FI, Allessie MA Vulnerability of rabbit atrium to reentry by hypoxia. Role of inhomogeneity in conduction and wavelength. Am J Physiol. 1992;262(1 Pt 2):H47-55.
  • 24) Sugiura T, Iwasaka T, Takahashi N, Yuasa F, Takeuchi M, Hasegawa T, et al. Factors associated with atrial fibrillation in Q wave anterior myocardial infarction. Am Heart J 1991;121:1409- 12.
  • 25) Mancia G, Facchetti R, Bombelli M, Grassi G, Sega R. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension. 2006 May;47(5):846-53.
  • 26) Pickering TG. The natural history of hypertension: prehypertension or masked hypertension? Journal of clinical hypertension 2007;9(10):807-10.
  • 27) Daichi Shimbo, Jonathan D. Newman and Joseph E. SchwartzMasked Hypertension and Prehypertension: Diagnostic Overlap and Interrelationships With Left Ventricular Mass: The Masked Hypertension Study AmerÕcan journal of Hypertension 2012 ; 25 (6) 664-671.
  • 28) Asayama K, Sato A, Ohkubo T, et al. The association between masked hypertension and waist circumference as an obesityrelated anthropometric index for metabolic syndrome: the Ohasama study. Hypertens Res 2009;32:438-43.

Maskeli Hipertansiyon ve P Dalga Dispersiyonu Arasındaki İlişkinin Değerlendirilmesi

Yıl 2023, Cilt: 20 Sayı: 1, 25 - 30, 27.04.2023

Serhat Çalışkan Mehmet Atay Şenel Altun

https://doi.org/10.35440/hutfd.1127459

Öz

Amaç: Atriyal fibrilasyon günlük pratikte en sık karşılaştığımız aritmidir. Hipertansiyon atriyal fibrilasyon için bağımsız risk faktörüdür. P dalga dispersiyonu atriyal fibrilasyon öngörmede kabul görmüş non-invaziv parametrelerden biridir. Çalışmamızda maskeli hipertansiyon tanısı ile takip edilen hastalarda P dalga sürelerinin kontrol grubuna göre farklılık gösterip göstermediği incelemeyi amaçladık.
Materyal Metod: Çalışmaya yaş ve cinsiyet açısından benzer 40 maskeli hipertansiyonu olan hasta ile 42 kontrol grubu olarak toplam 82 kişi alındı. Çalışmaya katılan bireylerin laboratuvar verileri ve elektrokardiyografi (EKG) parametreleri retrospektif olarak incelendi. Tüm katılımcıların EKG kayıtlarından P dalga süreleri hesaplandı.
Bulgular: P dalga dispersiyon süresi (44,88±5,63 ms ve 38,38±6,21 ms) ve P maksimum süresi (127,28±4,19 ms ve 121,38±6,05 ms) maskeli hipertansiyon grubunda kontrol grubuna göre anlamlı düzeyde yüksek saptandı (p<0,001). Maskeli hipertansiyon tanılı bireylerin vücut kitle indeksi değerleri (26,28±2,23 ve 24,9±2,89 p<0,05) kontrol grubuna göre istatistiksel olarak yüksek saptandı. Hastaların laboratuvar verileri arasında anlamlı fark saptanmamıştır.
Sonuç: P dalga dispersiyonu ve P maksimum süresi maskeli hipertansiyonu bulunan hastalarda uzamıştır ve bu parametreler aritmi tahmini için kullanılabilir.

Anahtar Kelimeler

Maskeli Hipertansiyon Aritmi P dalga dispersiyonu

Kaynakça

  • 1) Vas LE, Oren A, Uiterwaal C, Gorissen W.H.M, Diederick E, Grobbee Bots M.L. Adolescent Blood Pressure And Blood Pressure Tracking İnto Young Adulthood Are Related To Subclinical Atherosclerosis: The Atherosclerosis Risk in Young Adults (Arya) Study. American Journal of Hypertension, 2003; 16:549-55.
  • 2) Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 2018 Oct;36(10):1953-2041.
  • 3) Hypertension EETFftMoA. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens. 2013;31(10):1925-38.
  • 4) Bobrie G, Clerson P, Menard J, Postel-Vinay N, Chatellier G, Plouin, PF, 2008. Masked hypertension: A systematic review, J Hypertens, 26(9), 1715-1725.
  • 5) Bjorklund K, Lind L, Zethelius B, et. al. İsolated ambulatuary hypertension predicts cardiovascular morbidity in elderly men. Circulation 2003;107(9):1297-1302.
  • 6) Verdecchia P, Schilatti G, Borgioni C, et al. Cigarette smoking, ambulatory blood pressure and cardiac hypertrophy in essential hypertension. J Hypertens. 1995;13:1209– 1215.
  • 7) Levy S. Factors predisposing to the development of atrial fibrillation. PACE 1997;20:2670-74.
  • 8) Tyoshima H, Park YD, Ishikawa Y, et al: Effect of ventricular hypertrophy on conduction velocity of activation trent in the ventricular myocardium. Am 1 Cardiol 1982;49: 1938-1945.
  • 9) Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis and redisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998;82:2N–9N.
  • 10) Dilaveris PE: P wave dispersion and atrial arrhytmias. Türk Aritmi Pacemaker ve Elektrofizyoloji Dergisi 4: 187-96, 2006.
  • 11) Dilaveris PE, Gialafos EJ, Sideris SK, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998; 135 (5): 733-8.
  • 12) Dilaveris PE, Gialafos EJ, Chrissos D, Andrikopoulos GK, Richter DJ, Lazaki E, Gialafos JE. Detection of hypertensive patients at risk for paroxysmal atrial fibrillation during sinus rhythm by computer-assisted P wave analysis. J Hypertens 1999; 17: 1463- 1470.
  • 13) Yilmaz R, Demirbag R P-wave dispersion in patients with stable coronary artery disease and its relationship with severity of the disease. Journal of Electrocardiology 2005:38;279–284.
  • 14) Turhan H, Yetkin E, Senen K, Yilmaz MB, Ileri M, Atak R, et al. Effects of percutaneous mitral balloon valvuloplasty on P-wave dispersion in patients with mitral stenosis. Am J Cardiol 2002;89:607-09.
  • 15) Turhan H, Yetkin E, Atak R, Altinok T, Senen K, Ileri M, et al. Increased P-wave duration and P-wave dispersion in patients with aortic stenosis. Ann Noninvasive Electrocardiol 2003;8:18.
  • 16) Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370-5.
  • 17) Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace 2010; 12(10): 1360-1420.
  • 18) P. S. Moran , C. Teljeur, P. Harrington, S. M. Smith, B. Smyth, J. Harbison, C. Normand ve M. Ryan, “Cost-Effectiveness of a National Opportunistic Screening Program for Atrial Fibrillation in Ireland”, Value in Health, c. 19, sayı 8, ss. 985– 995, 2016.
  • 19) Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365: 217–223.
  • 20) Ezzati M, Lopez AD, Rodgers A, Hoorn SV, Murray JL. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360: 1347–1360.
  • 21) Mattioli AV, Bonatti S, Monopoli D, Zennaro M, Mattioli G Left atrial remodelling after short duration atrial fibrillation in hypertrophic hearts. Heart. 2005;91(1):91-92.
  • 22) Calhoun DA, Bakir S, Oparil S. Etiology and pathogenesis of essential hypertension. Crawford MH, DiMarco JP. Cardiokogy. Mosby 2001 London pp. 3 1.1-3 1.10.
  • 23) Lammers WJ, Kirchhof C, Bonke FI, Allessie MA Vulnerability of rabbit atrium to reentry by hypoxia. Role of inhomogeneity in conduction and wavelength. Am J Physiol. 1992;262(1 Pt 2):H47-55.
  • 24) Sugiura T, Iwasaka T, Takahashi N, Yuasa F, Takeuchi M, Hasegawa T, et al. Factors associated with atrial fibrillation in Q wave anterior myocardial infarction. Am Heart J 1991;121:1409- 12.
  • 25) Mancia G, Facchetti R, Bombelli M, Grassi G, Sega R. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension. 2006 May;47(5):846-53.
  • 26) Pickering TG. The natural history of hypertension: prehypertension or masked hypertension? Journal of clinical hypertension 2007;9(10):807-10.
  • 27) Daichi Shimbo, Jonathan D. Newman and Joseph E. SchwartzMasked Hypertension and Prehypertension: Diagnostic Overlap and Interrelationships With Left Ventricular Mass: The Masked Hypertension Study AmerÕcan journal of Hypertension 2012 ; 25 (6) 664-671.
  • 28) Asayama K, Sato A, Ohkubo T, et al. The association between masked hypertension and waist circumference as an obesityrelated anthropometric index for metabolic syndrome: the Ohasama study. Hypertens Res 2009;32:438-43.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Serhat Çalışkan 0000-0002-0260-5463

Mehmet Atay 0000-0003-0011-190X

Şenel Altun 0000-0002-4819-5949

Erken Görünüm Tarihi 27 Nisan 2023
Yayımlanma Tarihi 27 Nisan 2023
Gönderilme Tarihi 7 Haziran 2022
Kabul Tarihi 13 Eylül 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 20 Sayı: 1

Kaynak Göster

Vancouver Çalışkan S, Atay M, Altun Ş. Maskeli Hipertansiyon ve P Dalga Dispersiyonu Arasındaki İlişkinin Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(1):25-30.
 Kapak Resmi İndir

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty