International Medical Journal, Vol. 23., Iss. 2, 2017, P. 11−19.
THE FEATURES OF STRUCTURAL AND FUNCTIONAL STATE OF THE HEART IN PATIENTS WITH HYPERTENSION AFTER STROKE
Ukrainian State Research Institute of Medical and Social Problems of Disability, Ministry of Health of Ukraine, Dnipro, Ukraine
Structural and functional characteristics of the heart state were investigated in patients with grade 3 hypertension in the remote period after ischemic stroke. All patients were performed circadian blood pressure monitoring, Doppler echocardiography, ultrasonography of brachiocephalic arteries. Left ventricular hypertrophy occurred in almost half of the patients. The persons with concentric and eccentric left ventricular hypertrophy had diastolic and systolic dysfunction (increase in size and index of left atrial end−diastolic size and volume, end−systolic index size and end−diastolic volume), left ventricle compensatory hypertrophy (increased thickness of the posterior myocardial wall and interventricular septum, and myocardial weight and mass index). The patients with hypertension with eccentric hypertrophy were characterized by right ventricular diastolic dysfunction (increased are and right atrium area index). At concentric remodeling the patients with the history of stroke demonstrated a significant reduction in end−diastolic volume and size and their indices and increase in the thickness and relative thickness of the left ventricle myocardium posterior wall. In all cases, these changes were due to duration of uncontrolled arterial hypertrophy, constitutional features, remodeling of the heart and blood vessels. Determining the factors influencing the structural and functional features of the heart in patients with hypertension should be the basis for stratification of total cardiovascular risk and development of individual programs for rehabilitation of disabled persons with this disease.
Key words: arterial hypertension, stroke, heart remodeling, heart structures.