Dynamics of left heart deformation parameters in patients with essential hypertension under long-term treatment
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Abstract
The aim – to investigate remodeling of left heart chambers in patients with essential hypertension and left ventricular hypertrophy (LVH) under one-year treatment with renin-angiotensin system blockers by means of longitudinal, circular deformation of left ventricle (LV) myocardium and contractile, reservoir and conductive functions of left atrium (LA).
Material and methods. The study involved 64 patients (women – 56 %) with arterial hypertension. Patients were divided into groups. 22 patients receiving angiotensin II receptor blockers (ARB), mean age 57.5±1.6 years, constituted group 1. The 2nd group included 26 patients on angiotensin-converting enzyme inhibitors (ACEI), mean age 59.4±1.4 years. Besides, patients were divided depending on LVH severity: group A was presented by 35 patients with mild and moderate LVH; group B – 13 patients with severe LVH. In all patients we performed echocardiography and speckle tracking echocardiography with analysis of longitudinal global systolic strain (LGSS), circumferential global systolic strain (CGSS) and their rates, early (EDSR) and late LV diastolic strain, LA early and late diastolic SR, LA systolic deformation (LASD).
Results and discussion. Longitudinal contractile LV function improved under treatment. This was supported by LGSS increase by 6 and 5 % in groups 1 and 2, respectively. When diastolic function was analyzed, EDSR was found to be higher by 6 and 4 % in groups 1 and 2, respectively at the end of observation period. Also, LASD was revealed to be higher in groups 1 and 2 by 9 and 8 %, respectively, compared to that before treatment. Thus, treatment with ARBs and ACEIs resulted in improvement of both systolic and diastolic functions of LV and reservoir LA function.
Conclusion. In groups A and B myocardial mass index decreased by 5 and 10 %, respectively. In the group with severe LVH along with longitudinal improvement CGSS reliably increased by 10 % compared to that before treatment.
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