V.М. Kovalenko, E.G. Nesukay, E.Yu. Titov, N.S. Polenova, O.O. Danylenko.Features of structural and functional state of the left heart in hypertensive patients with different types of remodeling.

The aim – to examine features of structural and functional state of the left heart in patients with essential hypertension (EH) in different types of left ventricular (LV) remodeling.
Material and methods. The study involved 100 patients with essential hypertension (men – 60 %) in average age (55.5±0.5) years. According to the type of LV remodeling patients with essential hypertension were divided into four groups. The first group consisted of 23 patients with normal LV geometry. The second group included 16 patients with concentric LV remodeling. The third group included 29 patients with concentric LV hypertrophy (LVH), and the fourth group consisted of 32 patients with eccentric LVH. All patients were performed echocardiography and speckle tracking echocardiography.
Results and discussion. There were dysfunction of longitudinal and circumferential components of LV myocardial deformation in the 3rd and 4th groups compared to the 1st and 2nd groups and there was no relationship between the type of LV remodeling and radial component of the LV myocardial deformation. Increase of late-diastolic deformation of the left atrium (LA) in the group 2 by 17.6 % (Р<0.05) compared to the patients of group 1 can be considered as a compensatory mechanism of adequate LV filling in response to increasing ventricular pressure overload. Depletion of LA contractile function allowance in patients with concentric and eccentric LVH causes dilatation LA, decreasing LA reservoir function by 22.1 % (Р<0.05) and 26 % (Р<0.05) and LA conduit function by 30 % (Р<0.05) and 24 % (Р<0.05) respectively, compared to those in patients with normal LV geometry. Conclusions. In patients with essential hypertension and left ventricular concentric remodeling we observed violations of the longitudinal component of LV myocardial deformation and enhanced contractile function of the LA. In patients with essential hypertension and concentric and eccentric LVH longitudinal as well as circumferential component of LV myocardial deformation were abnormal and we observed also decreasing of LA reservoir and conduit functions.

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