Search

Objectives: To study the electrocardiogram (ECG) based QT parameters namely QTc (heart rate corrected QT), QTd (QT dispersion) in treated type 2 diabetics (T2D) and the effect of hypertension (HTN), blood pressure (BP) control, and antihypertensives used on the above parameters. Materials and Methods: We performed a cross-sectional study in a tertiary care hospital of Gujarat, India, on 199 T2D (67 males and 132 females). Standard 12-lead ECG was recorded to derive QTc (Bazett's formula), QTd, and ECG left ventricular hypertrophy (LVH). QTc >0.43 s in male and >0.45 s in female and QTd >80 msec were considered abnormal. Results: Hypertensives (n = 138) and normotensives (n = 61) were comparable for most confounders. Hypertensives had better profile of QTc and QTd than normotensives. T2D with controlled BP revealed slightly better, though insignificant; QTc, QTd than those with BP uncontrolled. QT parameters were not significantly correlated with age, heart rate, or BP. Qualitative differences exceeded quantitative difference in QTc and QTd evaluation. There was no significant effect of use or nonuse of preventive pharmacotherapy on QT parameters. Conclusion: Low-to-moderate prevailing cardiac repolarization abnormality in T2D with very low ECG LVH was unaffected by HTN as a disease, its control status, and treatment modalities suggesting primary preventive role of antihypertensive use without class difference. [ABSTRACT FROM AUTHOR]

Objectives: To study the effect of disease duration, treatment and risk factors on QTc interval among young hypertensives. Materials and Methods: A case-control study was conducted on 142 hypertensives (60 males, 82 females) taking calcium channel blocker (CCB) or angiotensin-converting enzyme inhibitor (ACEI) as monotherapy. After blood pressure measurement, we recorded lead II electrocardiograph with minimum ten waveforms. QTc was derived from average of ten values using Bazett's formula. QTc interval >0.43 s in male and >0.45 s in female was considered abnormal. Results: Cases had mean duration of hypertension 5 years, mean age of 40 years, and poor blood pressure control (systolic blood pressure >140 and diastolic blood pressure >90 mm of Hg). Newly diagnosed hypertensives had significantly higher QTc values than the matched known cases (0.44 vs. 0.42 s, P < 0.05). Known hypertensives did not differ significantly in QTc values by the duration of disease. CCB users showed small, insignificant disadvantage for abnormally prolonged QTc values than ACEI users. With coexisting diabetes, smoking, and positive family history of hypertension, there was odds risk of 7.69, 2.75, and 2.54, respectively for prolonged QTc. Conclusion: Our study showed prolonged QTc in hypertensives more so in newly diagnosed, unaffected by duration or use of ACEI, or CCB but associated with modifiable risk factors. This underscores high risk of repolarization abnormality-induced future events, suggesting early screening of hypertension, strict blood pressure control, optimum use of QTc measurement, and preventive pharmacotherapy to reduce this aftermath. [ABSTRACT FROM AUTHOR]

Purpose: Remarkable and uncontrollable changes with modification during pregnancy are connected with the autonomic control and consequently with the heart rate variability (HRV). Heart rate variability is a sum of different mechanisms and if pregnancy is a state of change, these modifications could be extracted from HRV analysis. Objective: To assess the effect of pregnancy on heart rate variability among pregnant mothers during first trimester of pregnancy and third trimester of pregnancy. Materials and Methods: HRV was measured for 5 minutes of continuous recording of electrocardiogram (ECG) lead II, using windows based HRV analysis system variowin-HR after obtaining permission from the Institutional Review Board of Government Medical College, Bhavnagar and written consent from 30 pregnant subjects and 30 non-pregnant control subjects at autonomic function lab, Dept of Physiology, Bhavnagar. Result: Frequency domain parameters, very low frequency (VLF), low frequency (LF), high frequency (HF) and HF normalized unit (nu) were significantly decreased and LF (nu) and LF/HF significantly increased in pregnant subject in 3rd trimester as compared to their 1st trimester of pregnancy. Time Domain parameters like SDNN, RMSSD, SDSD, NN50 count, pNN50, SD1/SD2, triangular HRV index and average R-R interval were significantly decreased during 3rd trimester of pregnancy. Conclusion: The inhibition of resting parasympathetic activity or vagal blockage and an increment of the sympathetic modulation during the 3rd third trimester of gestation in pregnancy as compared to their 1st trimester and healthy non-pregnant subjects. Sympathovagal imbalance and abnormally low HRV may more pronounce during later stage of normal pregnancy. [ABSTRACT FROM AUTHOR]