GENDER- AND AGE-SPECIFIC PECULIARITIES OF LEFT HEART REMODELING IN PATIENTS WITH ARTERIAL HYPERTENSION

V. Ivanov, T. Onyshchuk
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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.
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动脉高血压患者左心重构的性别和年龄特异性特征
本文确定了II期高血压患者左心改变的性别和年龄特异性,无论其程度如何。为此,我们对160名男女患者进行了全面的检查。研究队列分为4个亚组:第一组18 - 44岁的年轻男性(n = 40),第二组年轻女性(n = 40),第三组45 - 60岁的中年男性(n = 40),第四组中年女性(n = 40)。所有组的年龄和性别都具有可比性。根据现有标准对诊断进行了验证。所有纳入研究的人都接受了一般的临床和仪器检查方法,包括超声心动图(回声cg),通过超声诊断扫描仪“HI VISION AVINS”(“NITASNI”,日本)进行一维(m型),二维(b型),通过多普勒超声心动图和组织扫描模式,根据普遍接受的方法。结果显示,与同龄女性相比,年轻男性的LA尺寸/容积及其指数、主动脉直径值、左室、右室、心肌厚度及其质量、舒张和收缩应激水平显著增加。被检查的人的平均年龄,构成了主要群体,仅以LA的绝对/相对尺寸的增加为标志。最重要的形态学和功能参数的差异以及LA、LV、主动脉直径、RV、心肌厚度及其质量、舒张和收缩应激水平的增加恰好发生在中年女性,而不是年轻女性。在LP和左心室心肌质量计算指标中,2.7级重计算指标与年龄的相关性最强。确定了中年男性与中年女性左室结构重构本质上的根本差异。记录了左室正常几何形状的减少和左室同心重构的增加。对左室结构重塑的性质与年龄的关系进行的分析显示,与年轻女性相比,中年女性的左室结构重塑存在根本差异。同心圆重构明显减少,同心圆肥大明显增加。
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