[Myocardial hypertrophy and coronary insufficiency as a cause of arrhythmia in patients with hypertension]. / Gipertrofiia miokarda i koronarnaia nedostatochnost' kak prichina narusheniia ritma u bol'nykh gipertonicheskoi bolezn'iu.

AIM: To elucidate contribution of left ventricular hypertrophy (LVH) vs myocardial ischemia to rhythmic disorders in patients with essential hypertension (EH) and LVH. MATERIALS AND METHODS: Echocardiography, coronarography, treadmill test, 24-h ECG monitoring were included in examination of 69, 69, 68 and 63 patients, respectively. All of them had EH stage II and LVH. The comparison was made between the groups composed by LVH degree and by the presence or absence of coronary artery atherosclerosis (CAA). RESULTS: Subjective arrhythmia was recorded in 27% of the examinees, while objective one was registered by 24-h monitoring and treadmill test in 85.7 and 42.6% of the patients, respectively. Ventricular arrhythmia in EH stage II patients with LVH is associated for the most part with coronary insufficiency, often in the presence of atherosclerosis of the coronary artery. High-grade ventricular extrasystoles by B. Lown and M. Wolf and LVH degree were related. CONCLUSION: An essential role in the onset of supraventricular arrhythmia (SVA) in EH stage 2 patients with LVH belongs to the size of the left atrium and LVH degree. SVA is related to left ventricular myocardial ischemia.

[Late ventricular potentials in left ventricular hypertrophy in patients with stage-II hypertension]. / Otdalennye potentsialy zheludochkov pri gipertrofii levogo zheludochka u bol'nykh gipertonicheskoi bolezn'iu II stadii.

AIM: To evaluate diagnostic significance of high-resolution ECG in patients with blood hypertension (BH) stage II with left ventricular hypertrophy (LVH) in the presence or absence of angiographically verified atherosclerosis of the coronary arteries. MATERIALS AND METHODS: ECG (registration of late ventricular potentials by M. Simson and R. Haberl), echo-CG and coronaroventriculography were performed in 63 males with BH stage II. RESULTS: Late ventricular potentials (LVP) were detected according to M. Simson in 6.3% of the examinees, while according to R. Haberl in none of them. Duration of filtered complex QRS was normal in all the patients. LVP characteristics were not significantly different in the presence or absence of coronary atherosclerosis. Severe and moderate LVH patients differed significantly by duration of low-amplitude high-frequency signals. An inverse correlation existed between duration of low-amplitude signals in the end of filtered complex QRS and parameters of echo-CG. CONCLUSION: LVP registration both by M. Simson and R. Haberl failed to provide additional information on substrate of the arrhythmia in hypertension stage II patients with LVH free of clinical symptoms of tachyarrhythmia. However, there is an inverse correlation between duration of low-amplitude signals in the end of filtered complex QRS and thickness of interventricular septum, asymmetry index, left ventricular myocardial mass.