FEATURES OF MYOCARDIAL DEFORMATION PROPERTIES IN RELATION TO LEFT VENTRICULAR REMODELING TYPES IN PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Objective: to determine the features of myocardial deformation properties in relation to left ventricular (LV) remodeling types in patients with arterial hypertension (AH). Design and method: The study included 62 patients of both sexes, with I–III degrees AH (ESC/ESH, 2018), who are undergoing outpatient treatment at the Republican Specialized Scientific and Practical Medical Center of Cardiology. The average age of patients was 53.1 ± 11.3 years, and the average duration of AH was 6.7 ± 6.5 years. Speckle-tracking EchoCG was performed to obtain an objective and quantitative assessment of global and regional myocardial function using SIEMENS's ACUSON x700 PV 2.0 system. Deformation properties of the LV myocardium were analyzed using the TOMTEC-ARENA Software system (TTA2.40.00). Among parameters for assessing longitudinal deformation of the LV we selected: global longitudinal strain -GLS (%); Strain Rate-SR (s-1). To study the segmental LV contractility, we analyzed the apical 4-chamber, 3-chamber, and 2-chamber section, the LV section along the short axis at the level of the mitral valve cusps, papillary muscles, and apex. Results are presented as M±SD. Results: The examined patient sample revealed three groups of LV geometric models: group I, n=27 (45.3%) patients with normal geometry; group II, n=27 (45.3%) patients with concentric remodeling; group III, n=8 (12.9%) patients with concentric hypertrophy. The absolute GLS values of the LV were: in group I - 20.0 ± 2.95%, in group II - 15.2 ± 2.99%, and in group III - 13.5 ± 1.87%. Inter-group analysis revealed that in the group with normal geometry, myocardial deformation properties of the LV were not impaired compared to II and III groups, as indicated by the GLS value within the normal range in group I patients (p < 0.001). The lowest values of LV deformation were found in the group with concentric geometry, possibly influenced by factors such as the degree of hypertrophy, the presence of fibrosis in the myocardium, and diastolic dysfunction of the LV. Conclusions: Thus, in patients with AH and the presence of concentric hypertrophy, significant impairments in myocardial deformation properties of the LV are formed.