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Hipertansif Hastalarda Kinapril ve Nebivolol'ün QT Dispersiyonu Üzerine Etkileri

Journal Name:

  • Fırat Tıp Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objectives: QT dispersion (QTD) is thought to reflect spatial heterogeneity of ventricular refractoriness. We aimed to investigate and compare the effect of nebivolol and Quinapril on the QTD in patients with hypertension. Material and Methods: Patients with established or newly diagnosed hypertension were included. The QT interval was measured in all leads from a standard 12-lead ECG and QTD was defined as the difference between the maximum and minimum QT interval. The QTD values were corrected for heart rate using Bazett's formula (QTDC). Results: Groups (Quinapril, n= 27, Nebivolol, n=27) were similar with respect to demografic, echocardiographic, biochemichal and clinical variables. After four weeks of tretament a significant reduction was observed in systolic (p<0,0001 in both groups) and diastolic (p<0,0001 in both group) blood pressure, QTD (p= 0,014 and p= 0,0003 respectively), and QTDC (p= 0,011 and p= 0,0001 respectively). Nebivolol was more efective than Quinapril in reducing diastolic blood presssure (-13±9 and -8±5 p=0,037), while no differences were noted in treatment dependent changes for any other parameters between two groups. The reduction in QT indexes was significant after controlling for the change in blood pressure and heart rate. However the change in heart rate had a significant effect on the change in QTD (F=5.25, p=0.026) and QTDC (F=12.17, p= 0.001). Conclusion Short-term antihipertansive treatment with Quinapril or nebivolol improves ventricular repolarization homogeneity, which in part could be explained by the effect of these drugs on the sympathetic nerveous system activity. ©2007, Firat University, Medical Faculty
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Abstract (Original Language): 
Giriş: QT interval dispersiyonunun (QTD) ventrikül repolarizasyon inhomojenitesinin bir göstergesi olduğu düşünülmektedir. Bu çalışmada hipertansif hastalarda kısa süreli nebivolol ve kinapril tedavisinin QTD üzerine olan etkilerinin araştırılması amaçlandı. Gereç ve Yöntem: İlaç kullanmayan veya yeni tanı almış hipertansif hastalara sırasıyla kinapril veya nebivolol tedavisi başlandı. QT intervali yüzeyel EKG'de Q dalgasının başından T dalgasının sonuna kadar olan mesafe olarak ölçüldü ve değerler (QTC) Bazett formülü ile kalp hızına göre düzeltildi. Maximum ve minimum QT intervalleri arasındaki fark QTD olarak tanımlandı. Bulgular: Gruplar (Kinapril, n= 27, Nebivolol, n=27) demografik, ekokardiyografik, biyokimyasal ve klinik değişkenler bakımından benzerdi. Dört haftalık bir tedavi sonunda SKB (her iki grupta da p<0.0001), DKB (her iki grupta da p<0.0001), QTD (sırasıyla p=0.014 ve p=0.0003) ve QTDC (sırasıyla p=0.011 ve p=0.0001) değerlerinde belirgin bir azalma gözlendi. Nebivolol grubunda DKB düşüşü kinapril grubuna göre daha belirgin (-13±9 vs -8 ±5, p=0.037) olmakla birlikte diğer parametrelerde meydana gelen değişim her iki tedavi kolunda benzer olarak bulundu. Kan basıncı ve kalp hızı değişimi kontrol edildiğinde yine aralarında belirgin bir fark olmaksızın her iki grupta da QT interval parametrelerindeki anlamlı düşüşün devam ettiği görüldü. Ancak kalp hızındaki değişimin QTD (F=5.25, p=0.026) ve QTDC (F=12.17, p=0.001) değerlerindeki değişime anlamlı bir etkide bulunduğu gözlendi. Ayrıca kalp hızı değişimi QTD (r=0.307, p=0.24) ve QTDC (r=0.441, p=0.001) değişimi ile anlamlı pozitif bir korelasyon içindeydi. Sonuç: Kinapril ve nebivolol ile yapılan antihipertansif tedavi ventrikül repolarizasyon segmentinin stabilitesini artırmaktadır. Bu etki kısmen de olsa sempatik sinir sistemi aracılıklı olabilir ©2007, Fırat Üniversitesi, Tıp Fakültesi
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  • 3
190-196
  • Turkish

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