DYNAMICS OF LEFT VENTRICULAR DEFORMATION INDICATORS AND MARKERS OF CARDIAC REMODELING ST-2 AND CARDIOTROPHIN-1 IN POSTMENOPAUSAL WOMEN WITH ARTERIAL HYPERTENSION UNDER THE INFLUENCE OF COMBINED ANTIHYPERTENSIVE THERAPY

Abstract

Objective - to determine the effect of the combination of valsartan and hydrochlorothiazide on the parameters of the left ventricular deformation and the dynamics ofbiochemical markers of cardiac remodeling (cardiotrophin-1 and soluble ST-2) inpostmenopausal women with arterial hypertension.Material and methods. An open, prospective, controlled study included 100 postmenopausal women with stage I - II of arterial hypertension. Transthoracic and speckletracking echocardiography were performed on a Vivid E9 XDClear Console 4D Expert100 ultrasound scanner (General Electric, USA) with ECG synchronization. Ambulatorymonitoring of blood pressure was performed using the device ABPM-04 (Meditech, Hungary). The concentrations of cardiotrophin-1 and ST-2 were determined by the method ofenzyme-linked immunosorbent assay. After 6 months of treatment with a combination ofvalsartan and hydrochlorothiazide, all women were re-examined. Statistical analysis wasperformed using the Statistica 13.0 software package. All tests were two-sided;statistically significant differences were considered at p <0.05.Results. As a result of a 6-month treatment of patients with a combination of valsartan andhydrochlorothiazide, a significant decreasing of the interventricular septum thickness andLV myocardial mass index, increasing of the LV global longitudinal strain and a decreasing of the mechanical dispersion of segmental strain curves were recorded. Thepositive effect of combination therapy with valsartan and hydrochlorothiazide on thedynamics of cardiac remodeling markers has been established. The median of decreasingof cardiotrophin-1 was -37.93% (p <0.000001), and of soluble ST-2 was -19.74% (p =0.000046).Conclusions. Therapy with a combination of valsartan and hydrochlorothiazide during 6months helps to reduce the severity of left ventricular hypertrophy and improves thedeformation properties of the myocardium. For the first time it was found that thiscombination significantly reduced the concentration of cardiac remodeling and fibrosismarkers - cardiotrophin-1 and soluble ST-2.