Саратовский научно-медицинский журнал (Mar 2018)
Prediction of heart remodeling in patients with bronchial asthma
Abstract
The aim of the study was to identify cardiac remodeling in bronchial asthma (BA), to construct a mathematical model for its prediction to optimize diagnosis. Material and Methods. Atotal of 283 patients with asthma who underwent a comprehensive examination including general clinical, immuno-enzymatic (determination of the N-terminal fraction of the brain natriuretic propeptide, activity of the angiotensin-converting enzyme) and instrumental methods: ECG, ECHO, daily Holter monitoring of ECG, FVD. Results. The analysis of the obtained results showed that in patients with asthma, structural, geometric changes of the myocardium of the right and left ventricles were noted, increasing as the disease became more severe. The activation of local neurohormonal systems, primarily myocardial is no less important. An analysis of the relationship between the concentration of natriuretic peptide and the end-diastolic size of the right ventricle in BA patients revealed a moderate correlation relationship. There was a weak correlation between the right ventricular end-diastolic size, the right ventricular frontal wall thickness and the ACE level. The analysis of the relationship between the above dimensions of the right ventricle and the index of the balance of the autonomic nervous system was reliable. Conclusion. Thus, the development of cardiac remodeling in AD patients occurs against the background of the hyperactivation of neurohumoral systems, including sympathoadrenal, renin-angiotensin-aldosterone and the system of natriuretic peptides.