P248Markers of interstitial fibrosis in hypertensive patients with left ventricle hypertrophy:

Abstract

It′s well known that left ventricle (LV) geometry type is strongly associated with stroke and myocardial infarction in hypertensive patients. The most negative prognosis have persons with concentric hypertrophy of LV and concentric remodelling of LV. Both cardiomyocytes and extracellular matrix are involved in left ventricle remodelling process and their ratio determine disorders of left ventricle function and structure which result in complications. The purpose of the study is to evaluate levels of plasma markers of myocardial fibrosis in hypertensive patients with different types of left ventricle geometry models. Materials and methods: Were examined 324 patients with arterial hypertension (AH) 2-3 grade and ischemic heart disease (stable angina 2-3 functional class) complicated by CHF I-III NYHA functional class. The mean age of patients - 77 (61; 84) years. Patients with arrhythmias, diabetes mellitus were excluded from the study. As control group were enrolled 42 healthy persons (mean age - 70 (17) years). In all patients was performed ECG in 12 standard leads, EchoCG (ASE/EAE recommendations 2005) and were evaluated plasma levels of aldosteron, tissue inhibitor of metalloproteinases-1 (TIMP-1) and Insulin-like growth factor 1 (IGF-1). Statistical significance was defined at the level of methods for p<0,05. Results: As it can be seen from Table 1 The values of aldosteron (which known as interstitial fibrosis trigger) and TIMP-1 (plasma marker of interstitial fibrosis) were significant higher in patients with concentric hypertrophy and eccentric hypertrophy in comparison with hypertensive patients with normal geometry of LV and healthy persons. Conclusion: Thus, the results of the study show that levels of plasma markers of interstitial myocardial fibrosis indicate higher levels of interstitial fibrosis in hypertensive patients with such geometric models of left ventricle as concentric hypertrophy and concentric remodelling. | Parameters | Hypertensive patients | Healthy persons with normal geometry of LV n=42 | |:-------------------- | --------------------------- | ----------------------------------------------- | -------------------------- | | Normal geometry n=57 | Concentric remodelling n=32 | Concentric hypertrophy n=166 | Eccentric hypertrophy n=99 | | Aldosteron (pg/ml) | 121.54 (27.51)* | 95.8 (43.41) | 143.19 (38.95)*† | 144.5 (38.25)*† | 72.82 (31.39) | | TIMP-1 (ng/ml) | 276.91 (80.32)* | 249.82 (83.23)* | 403.13 (128.53)*† | 359.93 (119.54)*† | 103.44 (7.06) | | IGF-1 (ng/ml) | 162.56 (23.55) | 158.29 (18.91) | 155.51 (24.45) | 139.88 (19.74)* | 154.63 (21.69) | * Results are shown in M (SD).*- p<0.05 in comparison with healthy persons, †- p<0.05 in comparison with patients with normal geometry of LV Markers of interstitial fibrosis & LVH