TISSUE DOPPLEROGRAPHY IN EARLY DIAGNOSIS OF FUNCTIONAL MYOCARDIAL DISORDERS IN ARTERIAL HYPERTENSION

Aim. To determine the potential of tissue Dopplerography (TDG) for early diagnosis of functional myocardial disorders in patients with arterial hypertension (HT).Material and methods. 66 patients with HT were examined. Clinical examination, 24-hour ambulatory blood pressure monitoring, two-dimensional- and Doppler-echocardiography of transmitral blood flow, TDG of mitral annulus, determination of blood level of brain natriuretic peptide (BNP) were performed.Results. Regional disturbances of diastolic myocardial function are detected in patients with HT and normal transmitral blood flow. These disturbances are more expressed in left ventricle (LV) remodeling. The LV remodeling is also connected with disorders of the longitudinal myocardial contractile systolic function of the inferior wall. These disorders are more expressed in patients with HT and chronic heart failure (CHF). The average ratio of peak rates of the early transmitral blood flow and the diastolic myocardial movement (E/Ea), as well as the average level of BNP confirmed the moderate increase in end-diastolic pressure in LV.Conclusion. Regional disorders of diastolic myocardial function in patients with HT are detected before structural changes of LV even in normal transmitral blood flow. The LV remodeling is related to the disorders of diastolic and regional systolic myocardial function, which are accompanied with increase in BNP level. At the same time increased BNP level is especially related with increased E/Ea ratio, which is more earlier predictor of CHF in hypertensive patients

ARTERIAL STIFFNESS AND CHRONIC KIDNEY DISEASE: CAUSES AND CONSEQUENCES

Chronic kidney disease (CKD) is associated with increased cardiovascular risk. CKD is characterized by accelerated aging of vessels in which the age-related arterial stiffness increase is exacerbated by a number of uremia-related processes. Increased arterial stiffness is associated with structural and functional disorders, as well as with the increase in cardiovascular mortality in patients with CKD. Increased arterial stiffness is diagnosed at an early stage of CKD. Modern understanding of the mechanisms of increased risk of cardiovascular complications in CKD, the factors contributing to the loss of elasticity of the arteries, arterial stiffness increase consequences are analyzed. Data illustrating the twoway interaction between CKD and arterial stiffness and mechanisms of accelerated progression of arterial stiffness in CKD are presented.</p

Natriuretic peptides and chronic heart failure in arterial hypertension patients

The review is devoted to natriuretic peptides perspectives in left ventricular (LV) systolic and diastolic dysfunction assessment and LV hypertrophy diagnostics in arterial hypertension (AH) patients. The data describing possible antihypertensive therapy effects on brain natriuretic peptide level in AH patients are presented