The differential diagnostic value of serum homocysteine for white coat hypertension

The relationship of frontal QRS-T angle between patients with newly diagnosed true and white coat hypertension

OBJECTIVES

The frontal QRS-T (f-QRST) angle is a measure of depolarization and repolarization heterogeneity and may be a predictor of poor ventricular health. We aimed to investigate whether the f-QRST angle indicates myocardial damage and predicts newly diagnosed true hypertension (HT) in patients with white coat hypertension.

METHODS

We measured the f-QRST angle of 63 subjects with WHC and 105 patients with newly diagnosed HT. Laboratory tests and ABPM were followed up in all patients. The f-QRST angle was calculated on the surface ECGs.

RESULTS

Of the patients in the study, 38.9% were female and 61.1% were male. The mean age was calculated as 59 ± 11 years. A comparison between both groups with the f-QRST angles was seen to be statistically significantly higher in the true HT group. The results of the receiving operating characteristic curve showed that the AUC value of the f-QRST angle was 0.94 (95% confidence interval, 0.91-0.97), the cutoff value was 60.5°, the sensitivity was 89.5%, and the specificity was 81%.

CONCLUSION

In our study, the f-QRST angle was found to be lower in patients with WHC than in true hypertensive patients. We think that ECG, which is a simple test, can be used to distinguish between true HT and WHC.

A study of the clinical application value of ultrasound and electrocardiogram in the differential diagnosis of cardiomyopathy

OBJECTIVE

To investigate the clinical application values of electrocardiogram (ECG) combined with ultrasound cardiogram (UCG) in the differential diagnosis of cardiomyopathy.

METHODS

A total of 120 patients with cardiomyopathy who were admitted to our hospital were randomly divided into the dilated cardiomyopathy (DCM) group (60 cases) and the ischemic cardiomyopathy (ICM) group (60 cases). Both groups were examined using ECG combined with UCG. The ultrasonic values (aorta, LADI, LVDd, LVESD, RVID, SV, LVEF, LVET, EPSS, E/A, RV6, RV6/RMAX), morphological changes (thin and round left ventricular apex, spherical left ventricle, arch-shaped left ventricle, segmental wall-motion abnormalities (SWMAs), diffuse wall motion abnormalities (DWMAs), paradoxical ventricular wall motion) and heart valve regurgitation (aortic valve, mitral valve, tricuspid valve, pulmonary valve) were compared and analyzed.

RESULTS

The degree of chamber enlargement in the DCM group was remarkably higher than that in the ICM group, but the degree of LVEF and aortic enlargement were significantly lower than those in the ICM group (P<0.05). The detection rates of spherical left ventricle and DWMAs in the DCM group were 60.00% and 100.00% respectively, which was significantly higher than those (6.66% and 40.00%) of the ICM group (P<0.05), but the detection rates of thin and round left ventricular apex, arch-shaped left ventricle, SWMAs, and paradoxical ventricular wall motion were 53.33%, 66.66%, 46.66% and 20.00% respectively in the ICM group, which were markedly higher than those in the DCM group. The incidence rates of aortic valve, mitral valve, tricuspid valve and pulmonary valve in the DCM group were 66.66%, 100.00%, 46.66% and 76.66%, which were notably higher than those (36.66%, 93.33%, 26.66% and 40.00%) in the ICM group (P<0.05).

CONCLUSION

ECG combined with UCG examination can effectively improve the judgment rate and diagnosis accuracy of cardiomyopathy. Due to its high safety, ECG combined with UCG examination is worthy of clinical promotion and application.

Association between plasma homocysteine and hypertension: Results from a cross-sectional and longitudinal analysis in Beijing's adult population from 2012 to 2017

Plasma homocysteine (Hcy) levels are associated with elevated blood pressure. However, the causal association between Hcy levels and the risk of hypertension remains ambiguous. Taking the study design effect into consideration, this study aimed to investigate this issue through a cross-sectional and longitudinal analysis. Data were obtained from the Beijing Health Management Cohort study, which conducted routine health check-ups from 2012 to 2017. Multivariate logistic regression was used for the cross-sectional analysis, and a quadratic inference function approach was performed for the longitudinal analysis. A total of 30 376 subjects (mean age = 50.0 years) were included in the cross-sectional analysis, and a subgroup of 3913 subjects without hypertension at baseline was included in the longitudinal analysis. After adjusting for potential confounders, the risk of hypertension increased with Hcy levels in the cross-sectional analysis using the traditional definition of hypertension (OR = 1.262, 95% CI: 1.155-1.378, Q2 vs Q1; OR = 1.458, 95% CI: 1.335-1.593, Q3 vs Q1; OR = 1.520, 95% CI: 1.388-1.664, Q4 vs Q1) and the 2017 hypertension definition (OR = 1.159, 95% CI: 1.067-1.259, Q2 vs Q1; OR = 1.328, 95% CI: 1.221-1.445, Q3 vs Q1; OR = 1.328, 95% CI: 1.217-1.449, Q4 vs Q1). The longitudinal analysis showed that hypertension risk increased in the third quartile of Hcy (OR = 1.268, 95% CI: 1.030-1.560, Q3 vs Q1). Elevated total plasma Hcy may be used as a predictive biomarker for hypertension. Attention should be paid to gender-specific mechanisms when issuing precise precautions.