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.

Keywords

• артериальная гипертензия
• гипертрофия левого желудочка
• диастолическая дисфункция
• прогноз развития сердечной недостаточности