Overweight and early heart remodelling in women with arterial hypertension
Abstract
Aim. To compare left ventricular (LV) remodelling and LV myocardial mass indices (MMI) in overweight and nonoverweight women with arterial hypertension (AH). Material and methods. The study included 89 women (mean age 48,3±8,7 years) with AH, but no regular antihypertensive treatment at the study enrolment. By the levels of body mass index (BMI), all women were divided into two groups: 47 women with BMI 18-25 kg/m2 (Group I) and 42 women with BMI 26-29 kg/m2 (Group II). All participants underwent two-dimensional transthoracic echocardiography (EchoCG), with the calculation of LVMM, LVMMI adjusted to body surface area (BSA) or height to the power of 2,7, and remodeling indices. Results. Overweight, even without obesity, was linked to a statistically significant increase of LV wall thickness, LVMM and height-adjusted LVMMI (р=0,002), while BSA-adjusted LVMMI demonstrated only a tendency towards increase (р=0,06). The latter finding demonstrates that the traditional, BSA-adjusted LVMMI could result in under-diagnostics of LV hypertrophy (LVH) among overweight patients. Conclusion. To diagnose LVH early in overweight patients, LVMMI should be adjusted to height to the power of 2,7.
About the Authors
E. M. Khurs
Ural State Medical Academy. Yekaterinburg
Russian Federation
Russian Federation
A. N. Dmitriev
Ural State Medical Academy. Yekaterinburg
Russian Federation
Russian Federation
P. V. Andreev
Ural State Medical Academy. Yekaterinburg
Russian Federation
Russian Federation
A. V. Poddubnaya
Ural State Medical Academy. Yekaterinburg
Russian Federation
Russian Federation
M. G. Evsina
Ural State Medical Academy. Yekaterinburg
Russian Federation
Russian Federation
O. G. Smolenskaya
Ural State Medical Academy. Yekaterinburg
Russian Federation
Russian Federation
References
1. Levy D., Garrison R.J., Savage D.D. et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. New Engl J Med 1990; 322: 1561-6.
2. Chinali M., De Simone G., Roman M.J. et al. Impact of obesity on cardiac geometry and function in a population of adolescents: The Strong Heart Study. JACC 2006; 47: 2267-73.
3. Салтыкова М.М., Рогоза А.П., Ощепкова Е.В. и др. Проблема индексации массы миокарда левого желудочка на размеры тела у пациентов с избыточной массой тела. Тер. архив 2006; 9: 92-5.
4. Ковалева О.Н., Янкевич А.А., Нижегородцева О.А., Латогуз Ю.И. Методические подходы к выявлению гипертрофии левого желудочка при артериальной гипертензии с использованием эхокардиографии. Украiн. кардiол. ж. 2008; 4: 119-25.
5. De Simone G., Daniels S.R., Devereux R.B. et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. JACC 1992; 20(5): 1251-60.
6. Vakili B., Okin P., Devereux R. et al. Prognostic implications of left ventricular hypertrophy. Am Heart J 2001; 141: 334-41.
7. Liu J., Roman M., Pini R. et al. Prediction of mortality risk by different methods of indexation for left ventricular mass. JACC 1997; 29: 641-57.
8. Gosse P., Jullien V., Jarnier P. et al. Echocardiographic definition of left ventricular hypertrophy in the hypertensive: which method of indexation of left ventricular mass? J Hum Hypertens 1999; 13: 505-9.
9. Zoccali C., Benedetto F., Mallaamaci F. еt al. Prognostic impact of the indexation of left ventricular mass in patients undergoing dialysis. J Am Soc Nephrol 2001; 12: 2768-74.
10. Devereux R.B., Reichek N. Echocardiographic determination of left ventricular mass in man: anatomic validation of the method. Circulation 1977; 55: 613-8.
11. Du Bois D., Du Bois E. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 1916; 17: 863-71. 2007
12. Guidelines for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertension 2007; 25: 1105-87.
13. Stork T.V., Muller R.M., Pisce G. Noninvasive measurement of left ventricular filling pressures by means of transmitral pulsed Doppler ultrasound. Am J Cardiol 1989; 64: 655-60.
14. Шмидт Р., Тевс Г. Физиология человека: в 4 томах. Т. 3. Москва 1986; 288 с.
15. Levy D., Savage D.D., Garrison R.J., et al. Echocardiographic criteria for left ventricular hypertrophy: the Framingham heart study. Am J Cardiol 1987; 59: 946-60.
Review
For citations:
Khurs E.M., Dmitriev A.N., Andreev P.V., Poddubnaya A.V., Evsina M.G., Smolenskaya O.G. Overweight and early heart remodelling in women with arterial hypertension. Cardiovascular Therapy and Prevention. 2010;9(2):16-20. (In Russ.)
Views:
1478
Email this article 
