Association of load-induced increase in left ventricular filling pressure with changes in level of NT-proBNP and left ventricular hypertrophy in patients with arterial hypertension
Journal Title: Серце і судини - Year 2018, Vol 0, Issue 2
Abstract
The aim — to compare the morphofunctional status of left ventricle (LV) and Nterminal fragment of the brain natriuretic peptide precursor (NTproBNP) levels in patients with arterial hypertension and clinical symptoms of heart failure (HF) and preserved LV ejection fraction (EF) depending on the changes of E/e¢ during submaximal exercise testing. Materials and methods. The prospective study involved 84 patients aged 43 to 85 years hospitalized at cardiology departments of Oleksandrivska Clinical Hospital in Kyiv from January 2015 to February 2017 with symptoms of HF of ІІA—ІІІ stages by Strazhesko—Vasilenko classification and ІІ — ІІІ functional classes by NYHA with LV EF ³ 50 % and signs of LV diastolic dysfunction according to the data of echocardiography. During the physical exercise test, depending on E/e¢ ratio, the patients were divided into 2 groups: group 1 (n = 22; 61.1 %) — patients with E/e¢ > 13, group 2 (n = 14; 38.9 %) patients with E/e¢ < 13. Results and discussion. In patients of group 1, the thickness of the posterior wall of the LV (p < 0.01), LV myocardial mass index (LVMMI) (p < 0.05), enddiastolic (p < 0.02) and endsystolic indexes of the LV were higher (p < 0.05), while the lateral e¢ velocity (e¢ lat) was lower at rest (p < 0,05) than in group 2. Patients of group 1 also showed higher mean NTproBNP levels than those of group 2. In 42.8 % patients with clinical symptoms of HF and LV EF ³ 50 %, who had the status of LV diastolic function determined according to tissue doppler data, the E/e¢ was within the so called gray zone — from 9 to 13. Following submaximal exercise testing, 61 % patients reported an increase in this figure of over 13, which was associated with higher levels of NTproBNP compared to patients with Е/е¢ value of less than 13. Conclusions. In 42.8 % patients with clinical symptoms of HF and LVEF ³ 50 %, according to tissue dopplerography, Е/е¢ value is within the gray zone (9—13). An increase in Е/е¢ value of more than 13 in patients after a submaximal exercise testing is associated with a higher level of NTproBNP and a higher LVMMI than in patients with Е/е¢ value of less than 13.
Authors and Affiliations
O. V. Vasilenko
Keywords
Related Articles
- EP ID EP332374
- DOI 10.30978/HV2018277
- Views 145
- Downloads 0
Doppler flowmetry in determination and evaluation of blood flow characteristics in anterior abdominal wall vessels during lipoabdominoplasty
The aim — to determine the possibility of using Doppler blood flow in the vessels of the anterior abdominal wall in order to improve the results and develop new methods for treating patients with cosmetic defects of the...
Tranexamic acid in intensive therapy of bleeding with different genesis
The problem of acute bleeding is relevant both in the medical and in the organizational aspects, and not only for Ukraine. The success of treatment is determined by a timely diagnosis and the speed of emergency medical c...
Pathogenetic justification and clinical significance of using arginine for prevention of critical ischemia of lower extremities and fatal manifestations of multifocal atherosclerosis
The aim — to investigate the results of treatment with L‑arginine of patients with intermittent claudication for prevention of critical stages of limb ischemia. Materials and methods. 86 patients with intermittent clau...
Infarction mask of aortoarteritis
Arteritis Takayasu (AT) belongs to the group of systemic vasculitis with a predominant lesion of vessels of large diameter. This disease is characterized by granulomatous inflammation of the aorta and its main branches....
Endometrioma of the rectus abdominis
Endometriosis is determined if the endometrial tissue is located outside the uterine cavity. Endometrial tissue can be localized in the peritoneum, vagina, scar tissue, cervix, fallopian tubes, rectum, urinary tract, Dou...