Podpalov V.P., Balashenko N.S.
Remodelling of the cardiovascular system in patients with arterial hypertension of the 1st and the 2nd degree
Education establishment "Vitebsk State Order of Peoples’ Friendship Medical University", Belarus
Abstract.
Objective. To study the cardiovascular system remodelling in patients with arterial hypertension of the 1st and the 2nd degree.
Material and methods. 265 patients with arterial hypertension of the 1st and the 2nd degree as well as persons constituting the control group were examined. The data of the standard questionnaire, office BP measurement, ambulatory blood pressure monitoring, electrocardiography (ECG), Holter ECG monitoring, echocardiography, brachiocephalic arteries ultrasound investigation, pulse wave velocity determination, biochemical serum and urine analyses results (lipid parameters, C-reactive protein, glucose, creatinine and microalbumin) were evaluated.
Results. Remodelling processes in patients with arterial hypertension of the 1st and the 2nd degree were revealed according to the ECG data, the results of echocardiography. Arteries remodelling processes in patients with arterial hypertension of the 1st and the 2nd degree were ascertained in comparison with practically healthy surveyed persons on the basis of the evaluation of pulse wave velocity by rheography method, changes in the structure of the arterial wall by ultrasound. It has also been found that in patients with arterial hypertension of the 1st and the 2nd degree changes in biochemical parameters of blood serum are observed in the form of higher values of TC, triglycerides, LDL-C, C-reactive protein and lower levels of HDL-C compared with those of the control group.
Key words: arterial hypertension, remodelling, cardiovascular system.
References
1. Mrochek AG, Nechesova TA, Korobko IYu, Liventseva MM, Pavlova OS, Pristrom AM. Diagnostika, lechenie i profilaktika arterial'noi gipertenzii: natsional'nye rekomendatsii [Diagnostics, treatment and prophylaxis of arterial hypertension: national references]. Minsk, RB; 2010. 52 р.
2. Floria VG. Rol' remodelirovaniia levogo zheludochka v patogeneze khronicheskoi nedostatochnosti krovoobrashcheniia [A role of remodeling of a left ventricle in a pathogenesis of a chronic circulatory unefficiency]. Kardiologiia. 1997;(5):63-70.
3. Safar ME, Levy BI, Struijker-Boudier H. Current Perspectives on Arterial Stiffness and Pulse Pressure in Hypertension and Cardiovascular Diseases. Circulation. 2003 Jun;107(22):2864-9.
4. Miliagin VA, Komissarov VB. Sovremennye metody opredeleniia zhestkosti sosudov [Modern methods of determination of rigidity of vessels]. Arterial'naia gipertenziia. 2010;16(2):134-43.
5. Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE. Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation. 1997 Sep;96(5):1432-7.
6. Zanchetti A, Bond MG, Hennig M, Neiss A, Mancia G, Dal Palù C, Hansson L, Magnani B, Rahn KH, Reid JL, Rodicio J, Safar M, Eckes L, Rizzini P. Calcium antagonist lacidipine slows down progression of asymptomatic carotid atherosclerosis: principal results of the European Lacidipine Study on Atherosclerosis (ELSA), a randomized, double-blind, long-term trial. Circulation. 2002 Nov;106(19):2422-7.
7. Podpalov VP, Manak NA, Prokoshina NR, Deeva, AD, Schastlivenko AI. Gruppy vysokogo riska smertnosti ot boleznei sistemy krovoobrashcheniia u lits s arterial'noi gipertenziei (po dannym desiatiletnego kogortnogo issledovaniia) [Groups at high risk of mortality from cardiovascular diseases in patients with arterial hypertension (according to a ten-year cohort study)]. Kardiologiia v Belarusi. 2011;(4):84-5.
8. Sosnowski M, Korzeniowska B, Tendera M. Left ventricular mass and hypertrophy assessment by means of the QRS complex voltage-independent measurements. Int J Cardiol. 2006 Jan;106(3):382-9.
9. Yakovenko EI. EKG-diagnostika gipertrofii levogo zheludochka [ECG diagnostics of a hypertrophy of a left ventricle]. Rossiiskii kardiologicheskii zhurnal. 2009;(5):79-83.
10. Pavlova OS, Nechesova TA. Tipy remodelirovaniia miokarda levogo zheludochka pri arterial'noi gipertenzii i vozmozhnosti medikamentoznoi korrektsii [Types of remodeling of a myocardium of a left ventricle at arterial hypertension and possibility of medicamental correction]. Meditsinskaia panorama. 2002;(6):5-8.
11. Nechesova TA, Korobko IYu, Kuznetsova NI. Remodelirovanie levogo zheludochka: patogenez i metody otsenki [Remodeling of a left ventricle: pathogenesis and methods of an assessment]. Meditsinskie novosti. 2008;(11):7-13.
12. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F. Rekomendatsii ESH/ESC 2013 g. po lecheniiu arterial'noi gipertonii [References of ESH/ESC of 2013 on treatment of an arterial hypertonia]. Journal of Hypertension. 2013;31(7):1281-357.
13. Al-Shali K, House AA, Hanley AJ, Khan HM, Harris SB, Mamakeesick M, Zinman B, Fenster A, Spence JD, Hegele RA. Differences between carotid wall morphological phenotypes measured by ultrasound in one, two and three dimensions. Atherosclerosis. 2005 Feb;178(2):319-25.
14. Spence JD, Hegele RA. Noninvasive phenotypes of atherosclerosis: similar windows but different views. Stroke. 2004 Mar;35(3):649-53.
15. Inaba Y, Chen JA, Bergmann SR. Carotid plaque, compared with carotid intima-media thickness, more accurately predicts coronary artery disease events: a meta-analysis. Atherosclerosis. 2012 Jan;220(1):128-33.
16. Johnsen SH, Mathiesen EB, Joakimsen O, Stensland E, Wilsgaard T, Løchen ML, Njølstad I, Arnesen E. Carotid atherosclerosis is a stronger predictor of myocardial infarction in women than in men: a 6-year follow-up study of 6226 persons: the Tromso Study. Stroke. 2007 Nov;38(11):2873-80.
17. Herder M, Johnsen SH, Arntzen KA, Mathiesen EB. Risk factors for progression of carotid intimamedia thickness and total plaque area: a 13-year follow-up study: the Tromso study. Stroke. 2012 Jul;43(7):1818-23.
18. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006 Nov;27(21):2588-605.
19. Safar ME, O’Rourke MF. Arterial stiffness in hypertension. Vol 23. Elsevier; 2006. 624 p.
20. O'Rourke MF, Nichols WW, Safar ME. Pulse wave form analysis and arterial stiffness: realism can replace evangelism and scepticism. J Hypertens. 2004 Aug;22(8):1633-4.
21. Temirsultanova TKh, Iliukhin OV, Ivanenko VV, Lopatin YuM. Pokazateli elastichnosti magistral'nykh arterii v norme: otsenka dvukh metodov diagnostiki v razlichnykh vozrastnykh gruppakh [Indicators of an elastance of the main arteries in norm: an assessment of two methods of diagnostics in various age groups]. Vestnik Volgogradskogo gosudarstvennogo meditsinskogo universiteta. 2010;(4):98-102.
22. Ross R, Harker L. Hyperlipidemia and atherosclerosis. Science. 1976 Sep;193(4258):1094-100.
23. Kukharchuk VV. Arterial'naia gipertoniia, narusheniia lipidnogo obmena i ateroskleroz [Arterial hypertonia, disturbances of a lipide exchange and atherosclerosis]. V: Chazov EI, red. Chazova IE, red. Rukovodstvo po arterial'noi gipertonii. Moscow, RF: Media Medika; 2005. р. 289-299.
24. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL, Rifai N, Smith SC Jr, Taubert K, Tracy RP, Vinicor F. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Associatio. Circulation. 2003 Jan;107(3):499-511.
25. Taubert D, Rosenkranz A, Berkels R, Roesen R, Schömig E. Acute effects of glucose and insulin on vascular endothelium. Diabetologia. 2004 Dec;47(12):2059-71.
