Frontal QRS-T angle may predict reverse dipping pattern in masked hypertensives

ABSTRACT

Aims

The frontal QRS-T (fQRST) angle is associated with worse cardiovascular outcome. The study aimed to assess the effect of reverse dipping pattern on f(QRST) angle in newly diagnosed masked hypertensive (MH) patients.

Materials and methods

Newly diagnosed 244 consecutive MH patients were included. According to dipping pattern, patients were grouped into three: dipper (n = 114), non-dipper (n = 106), and reverse dipper (n = 24) patterns. The f(QRST) angle, QT and corrected QT interval, and QT dispersion were measured from the 12-lead surface electrocardiogram and compared between groups.

Results

Of all, 51.2% (n = 125) were male. No gender difference was observed. Reverse dipper MH group had a significantly higher f(QRST) angle than the non-dipper and dipper MH groups (77.9 ± 8.6 vs. 32.4 ± 18.8 and 26.0 ± 18.5, respectively, p < .001). The cutoff value for f(QRST) angle of 51 predicts reverse dipping pattern (AUC: 0.84; 95% CI: 0.77–0.90; p < .001), with a sensitivity of 83% and a specificity of 78%.

Conclusion

This study revealed that f(QRST) angle is gradually increased starting from the dipper, non-dipper to reverse dipper masked hypertensives. The f(QRST) angle appears as an easy marker for the detection and risk stratification of hypertensive patients.

KEYWORDS:

• Ambulatory blood pressure monitoring
• electrocardiography
• frontal QRS-T angle
• non-dipper
• reverse dipper

Author contributors

LDA: Conceptualization, Methodology, Data curation, Writing-Original draft preparation MIH: Visualization, Investigation, Formal analysis, Validation. AO: Formal analysis, Visualization, Investigation. ZK: Investigation, Data curation, Writing-Original draft preparation, KK: Investigation, Data curation, Writing-Original draft preparation, SU: Conceptualization, Visualization, Supervision, Reviewing and Editing. All authors gave final approval and agree to be accountable for all aspects of work ensuring integrity and accuracy.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics committee approval

This study was approved by Ethics Committee of the Haydarpasa Numune Research and Training Hospital, 04.10.2021 (HNEAH-KAEK-2021/KK/258). The investigation confirms to the principles outlined in the Declaration of Helsinki.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.