Evaluation of Tp-e interval, Tp-e/QT AND Tp-e/QTc ratios in hypertensive urgent and hypertensive emergency patients

Introduction: Hypertensive crisis, one of the complications of hypertension, is defined as a systolic blood pressure above 180 mmHg and/or diastolic blood pressure above 120 mmHg. It is divided into two subgroups as hypertensive emergency and hypertensive urgent according to the presence or absence of end-organ damage. Hypertension and its complications are known to play a role in the pathogenesis of cardiac arrhythmias. Electrocardiography remains the gold standard for the diagnosis of cardiac arrhythmias. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios have recently been widely used as arrhythmia predictors. In this study, we aimed to evaluate Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in hypertensive urgent and hypertensive emergency patients to determine the risk of ventricular arrhythmia. We also evaluated the relationship between elevated blood pressure and Tp-e interval, Tp-e/QT and Tp-e/QTc ratios. Materials and Methods: In this study, hypertensive crisis patients admitted to Ordu University Emergency Department between 01.06.2022 and 31.01.2024 were prospectively evaluated. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were calculated and evaluated in the electrocardiograms of the patients. Results: A total of 235 patients were included in our study. 134 (57%) were female and 101 (43%) were male. 130 cases were included in the hypertensive urgent group, 45 cases in the hypertensive emergency group and 60 cases in the control group. The mean age of the subjects was 64.22±9.48 years for hypertensive emergency group, 60.85±10.5 years for hypertensive emergency group and 62.82±9.5 years for control group (p˃0.05). Tp-e interval, Tp-e/QT and Tp-e/QTc values of the subjects were found to have statistical significance in all three groups (p<0.001). Tp-e, Tp-e/QT, Tp-e/QTc values showed a moderate positive correlation with systolic and diastolic blood pressure. Conclusion: In our study, we found that Tp-e interval, Tp-e/QT and Tp-e/QTc ratios, which are predictors of ventricular arrhythmia, were significantly higher in patients admitted to the emergency department with hypertensive crisis. We also found that Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were positively correlated with systolic and diastolic blood pressures as a result of the spearmen test. Considering our findings, it can be said that the risk of arrhythmia development is high in the follow-up of hypertensive emergency and urgent patients. Therefore, we underline the need for monitorized follow-up of patients. In addition, since we found that the higher the blood pressure, the higher the risk of arrhythmia, we recommend that the clinician should be alert for arrhythmia in patients with higher blood pressure.