Relationship of the T-wave Tpeak-Tend interval with conduction system disorders in arterial hypertension

José C. Candia, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo; Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay
Osmar A. Centurión, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo; Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay
José F. Alderete, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo; Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay
Judith M. Torales, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo; Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay
Nelson J. Aquino, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo; Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay
Luis M. Miño, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo; Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay
Karina E. Scavenius, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo; Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay
Laura B. García, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo; Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay
Cristina Cáceres, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo, Central Department, Paraguay
Orlando J. Sequeira, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo, Central Department, Paraguay
Christian O. Chávez, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo; Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay
Jorge E. Martínez, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo, Central Department, Paraguay
Oscar A. Lovera, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo, Central Department, Paraguay
E. Javier Galeano, Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo, Central Department, Paraguay

Purpose: The Tpeak-Tend interval of the T wave has emerged as a new electrocardiographic marker of increased transmural dispersion of ventricular repolarization. We aimed to determine the presence of cardiac conduction system disorders in patients with systemic arterial hypertension (SAH) who have altered Tpeak-Tend interval of the T wave. Methods: The 67 patients with SAH were divided into two groups. Those with prolonged (≥ 77 ms) Tpeak-Tend intervals, 21 (31%) patients were in the study group. Those with normal (< 77 ms) Tpeak-Tend intervals, 46 (69%) patients were in the control group. Alteration of ventricular repolarization manifested as a prolongation of the Tpeak-Tend interval was detected by computerized electrocardiographic analysis tools. Results: The median value of QRS complex duration was significantly wider in the study group as compared to the control group (110 ± 12 ms vs. 94 ± 8 ms p < 0.001). There was a significantly greater incidence of left anterior hemiblock in the study group (14% vs. 0% p < 0.04). The median value of the QTc interval was significantly greater in the study group (440 ± 26 vs. 422 ± 15 p < 0.01). There was a significantly greater incidence of patients with prolonged QTc interval in the study group (33% vs. 11% p < 0.02). The median value of the Tpeak-Tend interval was significantly greater in the study group (84 ± 5 ms vs. 65 ± 4 ms p < 0.001), as well as, the Tpeak-Tend/QTc ratio in the study group (0.19 ± 0.1 vs. 0.16 ± 0.1 p < 0.001). Conclusion: There is a significantly greater ventricular repolarization disorders and abnormalities of the cardiac conduction system in SAH patients who possess altered Tpeak-Tend interval of the T wave.

Keywords: Arterial hypertension. Cardiac conduction system. Tpeak-Tend interval. QTc prolongation. T wave.