Krutost velikih krvnih žila i poremećaj EKG zapisa

master's thesis

• Title (english): Arterial stiffness and ECG abnormalities
• Author: Luka Katić
• Mentor: Bojan Jelaković (mentor)
• Committee member: Živka Dika (predsjednik povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Committee member: Bojan Jelaković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Detaljnija procjena rizika za buduće kardiovaskularne incidente treba imati znatno veću dubinu od postojećih tablica za brzu procjenu kardiovaskularnog rizika (npr. SCORE) i trebala bi se sastojati, među ostalim, i od mjerenja krutosti velikih krvnih žila preko procijenjene brzine pulsnog vala i EKG zapisa. Glavni cilj ove opservacijske longitudinalne studije je bio odrediti povezanost ePWV i EKG abnormalnosti te povezanosti broja smrtnih događaja i promatranih biomarkera. Populacija je podijeljena u 3 skupine prema arterijskom tlaku (AT): optimalni AT (<=119/79 mmHg), predhipertenzija (120-139/80-89 mmHg) i neliječena hipertenzija (>=140/90 mmHg). Provedeno istraživanje pronašlo je povezanost između Sokolow voltažnih kriterija za hipertrofiju lijeve klijetke i ePWV u skupini optimalnog AT-a. Iako uzročno-posljedična analiza nije napravljena, ova povezanost ukazuje na važnost neovisnog prediktora ePWV koji najvjerojatnije preko intermitentnog povišenja krvnog tlaka može dovesti do hipertrofije lijeve klijetke. Velik broj ispitanika s hipertrofijom lijeve klijetke nije bio direktno analiziran jer Sokolow voltažni kriteriji imaju visoku specifičnost (95%), a nisku osjetljivost (20-30%). Zbog opće poznate činjenice da je hipertrofija lijeve klijetke povezana s EKG markerima repolarizacije QT i QTc, ali i s fibrilacijom atrija zbog povišenog AT-a, postoji vjerojatnost da se pronašla indirektna povezanost ePWV s hipertrofijom lijeve klijetke i u skupinama PHT i NHT. Provedeno istraživanje pronašlo je povezanost između fibrilacije atrija i ePWV u skupini PHT, te povezanost QT i QTc s ePWV u skupini NHT. Dobiveni rezultati poticaj su dodatnim analizama na većem broju ispitanika, primarno u skupini ispitanika uključenih u EH-UH 2 projekt.

Abstract (english)

More detailed estimation for future cardiovascular events has to be deeper than quick assessment with, for example, SCORE tables and should include arterial stiffness measurement with ePWV and ECG analysis. The aim of this observational longitudinal study was to determine the correlation between ePWV and ECG abnormalities, as well as correlation between number of death events and analyzed biomarkers. Population was divided according to arterial pressure: optimal arterial pressure (<=119/79mmHg), prehypertension (120-139/80-89mmHg) and untreated hypertension (>=140/90mmHg). Conducted analysis has found correlation between Sokolow voltage criteria for left ventricular hypertrophy and ePWV in group with optimal arterial pressure. Even though causality was not analyzed, this correlation emphasizes the importance of ePWV as independent risk factor, which probably causes intermittent elevation of arterial pressure and can cause left ventricular hypertrophy. A lot of examiners with left ventricular hypertrophy has not been directly included in analysis since Sokolow voltage criteria has high specificity (95%) and low sensitivity (20-30%). Due to well-known facts that left ventricular hypertrophy is connected to ECG markers of repolarization, QT and QTc, but also to atrial fibrillation due to increased arterial pressure, there is a possibility that the indirect correlation was found between ePWV and left ventricular hypertrophy in the prehypertension and untreated hypertension group. Conducted analysis has found correlation between atrial fibrillation and ePWV in prehypertension and correlation between QT and QTc with ePWV in untreated hypertension group. The obtained results show the need for additional analyzes on a larger number of respondents, primarily in the group of respondents involved in the EH-UH 2 project.

• Keywords: EKG; Sokolow; QTc; procijenjena brzina pulsnog vala; krutost velikih krvnih žila
• Keywords (english): ECG; Sokolow; QTc; estimated pulse wave velocity; arterial stiffness
• Language: croatian
• URN:NBN: urn:nbn:hr:105:269759
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-24 10:30:52