Key result
Primary aldosteronism in hypertensive patients was associated with significantly increased Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios compared to primary hypertension (p < 0.05).
Why the study?
No study had evaluated Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios, which are used to evaluate ventricular repolarization changes and cardiac arrhythmia risk, in patients with primary aldosteronism.
Are Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios increased in hypertensive patients with primary aldosteronism compared to those with primary hypertension?
Observational (n=60)
Are Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios increased in hypertensive patients with primary aldosteronism compared to those with primary hypertension?
Ventricular repolarization parameters (Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios) are prolonged in patients with primary aldosteronism, suggesting an increased risk of cardiac arrhythmias linked to neuroendocrine changes.
May flag arrhythmia vulnerability in primary aldosteronism; leaves open whether Tp-e ratios predict events or guide therapy.
Introduction: There is no study evaluating the Tp-e/QT and Tp-e/QTc ratios with T wave peak to end interval (Tp-e interval) used for evaluation of cardiac arrhythmia risk and ventricular repolarization changes in patients with primary aldosteronism (PA). We aimed to investigate whether there was a change in Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in patients with PA.Method: Thirty patients with newly diagnosed hypertension (HT) and PA and 30 patients with primary HT were included. Twelve-lead electrocardiography (ECG) was performed in all patients. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were measured in addition to routine measurements in ECG.Results: Sodium, potassium, and plasma renin activity (PRA) were significantly lower in patients with PA; systolic and diastolic blood pressure, plasma aldosterone, plasma aldosterone/PRA were significantly higher in patients with PA (p < .05 for each one). When ventricular repolarization parameters were examined; while QT and QTc interval were similar between two groups, Tp-e interval, Tp-e/QT and Tp-e/QTc ratio values were significantly higher in patients with PA (p < .05 for each one). Tp-e interval, Tp-e/QT and Tp-e/QTc ratio values were positively correlated with the serum calcium, aldosterone, and aldosterone/PRA levels and negatively correlated with serum sodium, potassium, renin levels (p < .05 for each one). In linear regression analyses, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were independently associated with the aldosterone/PRA ratio.Conclusion: Tp-e interval, Tp-e/QT and Tp-e/QTc were increased in hypertensive patients with PA and were independently associated with aldosterone/PRA levels. This may be related to the changing neuroendocrine state in patients with PA.
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Demirtaş et al. (2019) conducted an observational in Hypertension with primary aldosteronism (n=60). Primary aldosteronism vs. Primary hypertension was evaluated on Tp-e interval, Tp-e/QT and Tp-e/QTc ratios (p=<0.05). Primary aldosteronism in hypertensive patients was associated with significantly increased Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios compared to primary hypertension (p < 0.05).
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