GENDER- AND AGE-SPECIFIC PECULIARITIES OF LEFT HEART REMODELING IN PATIENTS WITH ARTERIAL HYPERTENSION
PDF (Українська)

How to Cite

V. Ivanov, & T. Onyshchuk. (2019). GENDER- AND AGE-SPECIFIC PECULIARITIES OF LEFT HEART REMODELING IN PATIENTS WITH ARTERIAL HYPERTENSION. Eastern Ukrainian Medical Journal, 7(3), 194-207. Retrieved from http://eumj.med.sumdu.edu.ua/index.php/journal/article/view/36

Abstract

This article determines gender- and age-specific peculiarities of left heart changes in patients with stage II hypertension regardless of degree. For this purpose, a complete examination of 160 male and female patients was conducted. The examined cohort was divided into 4 subgroups: the 1st – young men aged 18 to 44 years (n = 40), the 2nd – young women (n = 40), the 3rd – middle-aged men from 45 to 60 years (n = 40) and the 4th – middle-aged women (n = 40). All groups were comparable to age and gender. Verification of the diagnosis was carried out on the basis of existing criteria. All persons who were included in the study underwent general clinical and instrumental methods of examination, which included echocardiography (Echo-CG) conducted by means of ultrasound diagnostic scanner “HI VISION AVINS” (“NITASNI”, Japan) in a one-dimensional (M-mode), two-dimensional (B-mode), by means of Doppler echocardiography and tissue scanning mode according to the generally accepted methodology.

The obtained results showed that a significant increase in LA dimensions/volumes and their indices, aortic diameter value, LV, RV, myocardial thickness and its mass, diastolic and systolic stress levels was recorded in young men as compared to women of the same age. The average age of the examined persons, that formed the main group, was marked only by an increase in the absolute/relative dimensions of LA. The most important differences in morphological and functional parameters and the increase in dimensions of LA, LV, aortic diameter, RV, myocardial thickness and its mass, diastolic and systolic stress levels were reported exactly in middle-aged women, as opposed to young women. Of the calculated indices of LP and mass of myocardium of left ventricle, the strongest association with age was shown by the indices calculated for recalculation in grade 2.7.

Fundamental differences in the nature of LV structural remodeling were determined in middle-aged men as compared to middle-aged women. A decrease in cases of LV normal geometry and an increase in cases with LV concentric remodeling were recorded. The conducted analysis of the nature of LV structural remodeling with respect to age showed fundamental differences in middle-aged women, as opposed to young women. A significant decrease in cases with concentric remodeling and an increase in cases with concentric hypertrophy was observed.

PDF (Українська)

References

1. Kovalenko VM, Kornatskyi VM. Problemy zdorovia i medychnoi dopomohy ta model pokrashchannia v suchasnykh umovakh. [Problem health and medical help support a model of painting in our minds: a health center for cardiologists, rheumatologists, therapists, body organizers and health professionals]. K: Hordon., 2016.p.261.
2. Arterialna hipertenziia. Onovlena ta adaptovana klinichna nastanova, zasnovana na dokazakh (2012 rik): praktychni rekomendatsii. Robocha hrupa z arterialnoi hipertenzii Ukr. asots. kardiolohiv. Arteryalnaia hypertenzyia. 2012.1. P. 96–152 (In Ukrainian)
3. Barnett OYu. Klitynne remodeliuvannia miokarda pry arterialnii hipertenzii yak faktor ryzyku rozvytku sertsevoi nedostatnosti ta ishemichnoi khvoroby sertsia [Cellular Myocardial Remodeling in Hypertension as a Risk Factor of Heart Failure and Coronary Artery Disease]. Liky Ukrainy plius.2014.2.pp.70-73. Retrieved from: http://nbuv.gov.ua/UJRN/liku_2014_2_22.
4. Bondar VM. Osoblyvosti kardioremodeliuvannia u patsiientiv z arterialnoiu hipertenziieiu ta metabolichnym syndromom [Features of cardio–remodeling in patients with hypertension and metabolic syndrome]. Aktualni problemy transportnoi medytsyny: navkolyshnie seredovyshche; profesiine zdorov’ia; patolohiia. 2016. 1, 52-60 (in Ukrainian).
5. Daniuk IO. Osoblyvosti remodeliuvannia livoho shlunochka u khvorykh na arterialnu hipertenziiu na tli podahry [Features of left ventricular remodeling in patients with hypertension on the background of gout]. Zaporozhskyi medytsynskyi zhurnal. 2018. 20(5),619–622 (in Ukrainian).
6. Kovalenko VM. Rekomendatsii z ekhokardiohrafichnoi otsinky diastolichnoi funktsii livoho shlunochka. Rekomendatsii robochoi hrupy z funktsionalnoi diahnostyky Asotsiatsii kardiolohiv Ukrainy ta Vseukrainskoi asotsiatsii fakhivtsiv z ekhokardiohrafii [Recommendations for echocardiographic evaluation of left ventricular diastolic function. Recommendations of the Working Group on Functional Diagnostics of the Association of Cardiologists of Ukraine and the All-Ukrainian Association of Echocardiography Specialists ]. Arytmolohiia. 2013.1(5).pp. 7–41 (In Ukrainian)
7. Tsang TS, Barnes ME, Gersh BJ et al. Prediction of risk for first age-related cardiovascular events in an elderly population: the incremental value of echocardiography. J Am. Coll. Cardiol.2003. 42.p. 1199–205.
8. Barnes ME, Miyasaka Y, Seward JB et al. Left atrial volume in the prediction of first ischemic stroke in an elderly cohort without atrial fibrillation. Mayo Clin. Proc. 2004.79. p. 1008–14.
9. Tsang TS, Barnes ME, Gersh BJ et al. Risks for atrial fibrillation and congestive heart failure in patients ≥65 years of age with abnormal left ventricular diastolic relaxation. Am.J. Cardiol.2004.93.p. 54–8.
10. Sabharwal N, Cemin R, Rajan K et al. Usefulness of left atrial volume as a predictor of mortality in patients with ischemic cardiomyopathy. Am. J. Cardiol. 2004. 94.p. 760–3.
11. Unifikovanyi klinichnyi protokol pervynnoi, ekstrenoi ta vtorynnoi (spetsializovanoi) medychnoi dopomohy. Arterialna hipertenziia: Nakaz vid 24.05.2012 r. № 384. [Unified clinical protocol for primary, emergency and secondary (specialized) medical care. Arterial hypertension: Order of 24.05.2012 № 384]. Kyiv.2012. p.72. (In Ukrainian)
12. ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur. Heart J.2013.34(28).P. 2159–2219.
13. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. (2015). 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, 28(1), 1–39.e14. doi: 10.1016/j.echo.2014.10.003.
14. Ganau A, Devereux RB. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol. 1992.19. p.1550–8.
15. Lang RM, Bierig M. Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Rekomendacii po kolichestvennoj ocenki struktury i funkcii kamer serdca. Ros.Kardiol. Zhurn. 2012.3 (1):1–28 (in Russian)
16. Rebrova OJu. Statisticheskij analiz medicinskih dannyh. Primenenie paketa prikladnyh programm STATISTICA. OJu Rebrova. Moskva : MediaSfera,2006.p.312 (in Russian).