Preview

Cardiovascular Therapy and Prevention

Advanced search

Heart failure development in patients with arterial hypertension and various variants of heart remodeling

Abstract

Aim. To study the prognosis of heart failure (HF) development in male and female patients with arterial hypertension (AH) and various heart remodeling variants.
Material and methods. The study included 48 men and 41 women of comparable age, with Stage II AH, at baseline free of HF or other diseases resulting in heart remodeling. All participants underwent Doppler echocardiography. The incidence of clinical HF cases during 5-year follow-up was analyzed by Kaplan-Meier method.
Results. During 5-year follow-up, HF symptoms were registered in 50 % men with left ventricular myocardial hypertrophy (LVH) and 9 % men without LVH, as well as in 22 % women with LVH and 14 % LVH-free women. Cumulative rate of AH men with normal LV geometry and manifested LV diastolic dysfunction (DD; Е/А<1,0), who demonstrated HF symptoms in 5 years, was 40 %; in AH men without LV DD, no HF symptoms were registered in the same period. In all AH men with Е/А>1,5, HF symptoms manifested during 5-year follow-up.
Conclusion. LV myocardial mass and manifested DD are independent predictors of HF development in AH patients. Prognostic value of manifested LV DD is higher than that for LVH.

About the Authors

V. R. Veber
Medical Education Institute, Yaroslav the Wise Novgorod State University, Veliky Novgorod
Russian Federation


M. P. Rubanova
Medical Education Institute, Yaroslav the Wise Novgorod State University, Veliky Novgorod
Russian Federation


S. V. Zhmaylova
Medical Education Institute, Yaroslav the Wise Novgorod State University, Veliky Novgorod
Russian Federation


P. M. Gubskaya
Medical Education Institute, Yaroslav the Wise Novgorod State University, Veliky Novgorod
Russian Federation


References

1. И. К. Шхвацабая, А. П. Юренев Гипертоническое сердце. Кардиология 1988; 28(12): 5–9.

2. Е. В. Шляхто, А. О. Конради Ремоделирование сердца при гипертонической болезни – патогенетические факторы и прогностическое значение. Кардиология СНГ 2003; 1: 20–5.

3. Levy D, Garrison RJ, Savage DD, et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham heart study. N Engl J Med 1990; 322: 1561–99.

4. Kannel WB. Left ventricular hypertrophy as a risk factor. J Hypertens 1991; 9(Suppl 2): 3–9.

5. Е. В. Шляхто, А. О. Конради, Д. В. Захаров, О. Г. Рудоманов Структурно-функциональные изменения миокарда у больных гипертонической болезнью. Кардиология 1999; 2: 49–55.

6. Ю. А. Карпов Лечение артериальной гипертонии: новые исследования – новые подходы. Кардиология 2003; 9: 87–90.

7. Mensah G, Pappas T, Koren M, et al. Comparison of classification severity by blood pressure level and World health organization for prediction concurrent cardiac abnormalities and subsequent complications in essential hypertension. J Hypertens 1993; 11: 1429–30.

8. Simone G, Mureddu G, Greco R, et al. Relation of left ventricular geometry and function to body composition in children with high causal blood pressure. Hypertension 1997; 30: 377–82.

9. Вайдья Р. Структурно-функциональные изменения левого желудочка у больных артериальной гипертензией при эффективной антигипертензивной терапии. Автореферат дисс канд мед наук. Великий Новгород 2004.

10. Deague JA, Wilson CM, Grigg LE, Harraps SB. Increased left ventricular mass is not associated with impaired left ventricular diastolic filling in normal individuals. J Hypertens 2000; 18(6): 757–62.

11. Devereux R.B., Lutas E.M., Casale P.N. et al. Standartization of M-mode echocardiographic left ventricular anatomic measurement. JACC 1984; 4: 1222–30.

12. Aurigemma GP, Gottdiener JS, Shemanski L, et al. Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: the cardiovascular health study. JACC 2001; 37(4): 1042–8.

13. Bella JN, Palmieri V, Roman MJ, et al. Mitral ratio of peak early to late diastolic filling velocity as a predictor of mortality in middle-aged and early adults: the Strong Heart Study 2002; 105(16): 1928–33.

14. Е. В. Шляхто, А. О. Конради, О. М. Моисеева Молекулярно-генетические и клеточные аспекты ремоделирования сердца и сосудов при гипертонической болезни (обзор). Тер архив 2004; 6: 51–8.

15. Sheider RE, Messerly FH. Hypertension and the heart. J Hum Hypertens 2000; 14: 597–604.


Review

For citations:


Veber V.R., Rubanova M.P., Zhmaylova S.V., Gubskaya P.M. Heart failure development in patients with arterial hypertension and various variants of heart remodeling. Cardiovascular Therapy and Prevention. 2007;7(7):21-24. (In Russ.)

Views: 11115


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)