Інсуліноподібний фактор росту-1 та ремоделювання лівого шлуночка серця у хворих на артеріальну гіпертензію з абдомінальним ожирінням

Abstract

The purpose of the work is to study the role of insulin-like growth factor-1 in the mechanisms of left ventricular remodeling in patients with arterial hypertension with abdominal obesity and arterial hypertension with normal body weight. Materials and methods. The study included 42 patients with arterial hypertension and abdominal obesity and 22 patients with arterial hypertension and normal body weight. All patients underwent general clinical laboratory and instrumental examination. The structural parameters of the heart were determined using echocardiographic studies. To assess the geometric rearrangement of the left ventricle, the relative thickness of its walls was calculated. Determination of the level of insulin-like growth factor-1 in serum was performed using enzyme-linked immunosorbent assay. Results and discussion. According to echocardiographic studies, left ventricular hypertrophy was diagnosed in 30 patients (71.4%) with arterial hypertension and obesity and in 9 (40.9%) patients with normal body weight (p <0.05). The advantage of hypertrophic types in the structural reconstruction of the heart and the formation of unfavorable types of geometry of the left ventricle in the presence of abdominal obesity in the subjects was found. It was found that in arterial hypertension with abdominal obesity, high levels of insulin-like growth factor-1 were found with normal geometry of the left ventricle, and with concentric hypertrophy and eccentric hypertrophy, a gradual probable decrease in this growth factor was observed and adhered to its comparison with the norm. The attention is drawn not only to the gradual decrease in insulin-like growth factor-1 from normal geometry to concentric and eccentric geometry, but also to the probable differences between this growth factor in concentric geometry and eccentric geometry, indicating the role of insulin-like growth factor-1 deficiency in cardiac remodeling. In normal weight hypertension, probable differences in this growth factor are obtained only between normal and eccentric left ventricular geometry. Сonclusion. Thus, the data obtained may indicate differences in the course of arterial hypertension, aggravated by abdominal obesity, in comparison with patients with hypertension with normal body weight. It is the association of arterial hypertension with abdominal obesity that causes a decrease in the synthesis of insulin-like growth factor-1, as a result of which there is an accelerated development of the pathological geometry of the left ventricle with the subsequent manifestation of heart failure. These results allow us to expand our understanding of the mechanisms of the formation of cardiac damage in patients with arterial hypertension and especially when it is combined with obesity