Influence of left ventricle remodeling on the rates of functional state in patients with arterial hypertension


DOI: https://dx.doi.org/10.18565/therapy.2019.4.28-34

Khadzegova A.B., Sinitsyna I.A., Borschevskaya M.V.

1) Department of general therapy, Department of clinical functional diagnostics of Faculty of continuing professional education of N.I. Pirogov Russian National research medical University of the Ministry of Healthcare, Moscow; 2) Department of clinical functional diagnostics of Faculty of continuing professional education of N.I. Pirogov Russian National research medical University of the Ministry of Healthcare, Moscow; 3) Department of clinical functional diagnostics of Faculty of continuing professional education of A.I. Evdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare
Objective: assessment of the left ventricle functional state in patients with uncontrollable hypertension depending on presence or absence of left ventricle hypertrophy.
Material and methods. Assessment of the functional state of the left ventricle (LV) depending on the presence of hypertrophy was performed in 157 patients with arterial hypertension. LV hypertrophy was detected in 129 (82,1%) patients, concentric remodeling – in 10 (6,4%), normal LV geometry – in 18 (11,5%).
Results. It has been found that in hypertension, impaired diastolic function and a decrease in the LV stroke volume precede myocardial hypertrophy and dilatation of the left atrium, which are traditional markers of heart damage due to hypertension. Earlier markers of diastolic dysfunction are a decrease in the peak velocity e´ in the area of the interventricular septumand an increase in E\e´ to the gray zone, indicating a violation of LV relaxation.
Conclusion. In patients with hypertension, the determination of these indicators should be a standard component of echocardiography conclusion.
Keywords: diastolic function, diastolic dysfunction, arterial hypertension, left ventricular hypertrophy
Read entire article

Literature


  1. Marwick T.H., Gillebert T.C., Aurigemma G. et al. Рекомендации по применению эхокардиографии при артериальной гипертензии у взрослых: отчет Европейской ассоциации по сердечно-сосудистой визуализации (EACVI) и Американского эхокардиографического общества (ASE). Под ред. А.Б. Хадзеговой, С.Т. Мацкеплишвили. Пер. с англ. Системные гипертензии. 2017; 14(2): 6–28. doi: 10.26442/2075-082X_14.2.6.

  2. American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society et al. ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/ SCMR 2011 appropriate use criteria for echocardiography. A report of the American College of Cardiology Foundation appropriate use criteria task force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance Endorsed by the American College of Chest Physicians. J Am CollCardiol. 2011; 57: 1126–66.

  3. Levy D., Garrison R.J., Savage D.D. et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart study. N Engl J Med. 1990; 322: 1561–66.

  4. Okin P.M., Roman M.J., Lee E.T. et al. Combined echocardiographic left ventricular hypertrophy and electrocardiographic ST depression improve prediction of mortality in American Indians: The strong heart study. Hypertension. 2004; 43: 769–74.

  5. Dokainish H., Zoghbi W.A., Lakkis N.M. et al. Incremental predictive power of b-type natriuretic peptide and tissue Doppler echocardiography in the prognosis of patients with congestive heart failure. J Am Coll Cardiol. 2005; 45: 1223–26.

  6. Roberto M. Lang, Luigi P. Badano, Victor Mor-Avi et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015; 28: 1–39. doi: https://doi.org/10.1016/j.echo.2014.10.003

  7. Sherif F. Nagueh, Otto A. Smiseth, Christopher P. Appleton et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imagings . J Am Soc Echocardiogr. 2016; 29: 277–314. doi: 10.1016/j.echo.2016.01.011

  8. Gaborieau V., Delarche N., Gosse P. Ambulatory blood pressure monitoring versus self-measurement of blood pressure at home: correlation with target organ damage. J Hypertens. 2008; 26: 1919–27. doi: 10.1097/HJH.0b013e32830c4368

  9. Jonathan N. Bellaa, Kristian Wachtellb, Vittorio Palmieria et al. Relation of left ventricular geometry and function to systemic hemodynamics in hypertension: The LIFE Study. Journal of Hypertension. 2001, 19: 127–34.

  10. Pierdomenico S.D., Di Nicola M., Pierdomenico A.M., Lapenna D., Cuccurullo F. Cardiovascular risk in subjects with left ventricular concentric remodeling at baseline examination: a meta-analysis. Journal of Human Hypertension. 2011: 25, 585–91. doi:10.1038/jhh.2011.24

  11. Ricardo Ladeiras-Lopes, Ricardo Fontes-Carvalho, Eduardo M. Vilela et al. Diastolic function is impaired in patients with prehypertension: data from the EPIPorto Study. Revista Española de Cardiología. 2018; 71(11): 926–34.

  12. Tatiana Kuznetsova; Lutgarde Thijs; Judita Knez et al. Prognostic value of left ventricular diastolic dysfunction in a general population. Am Heart Assoc. 2014; 3: e000789. doi: 10.1161/JAHA.114.000789

  13. Sharp A.S., Tapp R.J., Thom S.A. et al. Tissue Doppler e/e´ ratio is a powerful predictor of primary cardiac events in a hypertensive population: an ASCOT substudy. Eur Heart J. 2010; 31: 747–52.

  14. Benjamin E.J., D’Agostino R.B., Belanger A.J., Wolf P.A., Levy D. Left atrial size and the risk of stroke and death. The Framingham Heart study. Circulation. 1995; 92: 835–41.


About the Autors

Alla B. Khadzegova, MD, professor of the Department of general therapy of Faculty of continuing professional education of N.I. Pirogov Russian National research medical University of the Ministry of Healthcare. Address: 123182, Moscow, 3 Pekhotnaya str., City clinical hospital No 52 of Moscow Healthcare Department. Tel.: +7 (499) 196-19-69.
E-mail: alla.h@mail.ru
Irina A. Sinitsyna, applicant of the Department of clinical functional diagnostics of Faculty of continuing professional education of A.I. Evdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare. Address: 107014, Moscow, 7 Stromynka str., Bakhrusins brothers City clinical hospital of Moscow Healthcare Department.
Tel.: +7 (499) 268-24-98. Е-mail: fundiag@mail.ru
Marina V. Borschevskaya, PhD, associate professor of the Department of clinical functional diagnostics of Faculty of continuing professional education of N.I. Pirogov Russian National research medical University of the Ministry of Healthcare. Address: 19472, Moscow, 168 Volgogradsky prospect, Hospital of War veterans No 2. Tel.: +7 (499) 940-90-03 (1986). E-mail: fdiagnostikargmu@mail.ru


Similar Articles

Back to Content

Бионика Медиа