ANALYSIS OF HEMODYNAMICS AND MYOCARDIAL HYPERTROPHY OF THE LEFT VENTRICLE IN PATIENTS WITH ARTERIAL HYPERTENSION
Keywords:
left ventricular myocardial hypertrophy, hemodynamic parameters, аterial hypertensionAbstract
Aim. To study the prevalence of left ventricular myocardial hypertrophy and hemodynamic parameters in patients with arterial hypertension
Material and methods. The study included 50 patients with hypertension aged 47 to 68 years. According to echocardiography, we determined: the thickness of the interventricular septum, the thickness of the posterior wall of the left ventricle, diastolic function, left ventricular myocardial mass index, stroke index, cardiac index, total peripheral vascular resistance (TPVR).
Results. Left ventricular myocardial hypertrophy was detected in 64% of patients, asymmetric in 2%. The severity of hypertrophy increased with increasing severity of hypertension. There was a positive correlation between myocardial hypertrophy indicators and the severity of hypertension. Type 1 diastolic dysfunction was detected in 32% of patients. Hemodynamic changes in patients with 1st grade hypertension were characterized by a tendency towards the formation of a hyperkinetic type, and in grades 2 and 3 there was a tendency towards a decrease in the cardiac index and an increase in peripheral vascular resistance, which may indicate activation of the renin-angiotensin-aldosterone system (RAAS). In the presence of obesity, the severity of hypertrophy and the increase in peripheral vascular resistance increased.
Conclusion. Left ventricular myocardial hypertrophy in patients with hypertension was observed in 64% of cases, asymmetric hypertrophy – in 2%. Diastolic dysfunction of the delayed relaxation type was recorded in 32% of cases, only in 2nd and 3rd grades hypertension. The main factors in the development of hypertrophy were the severity of hypertension and obesity. In 1st grade hypertension there was a slight increase in the cardiac index and a decrease in peripheral vascular resistance. In patients with 2nd and 3rd grades hypertension, there was a tendency toward a decrease in cardiac index and an increase in peripheral vascular resistance. Obesity contributed to an increase in peripheral vascular resistance.
