PP.04.08] IMPACT OF ARTERIAL HYPERTENSION ON CLINICAL DEVELOPMENT OF AORTIC STENOSIS

Abstract

Objective: To evaluate influence of arterial hypertension on clinical development of aortic stenosis before and after valve replacement.Design and method: 72 patients (mean (SD) age 63.9 ± 11.8 years) with aortic stenosis who underwent aortic valve replacement. 50 were males, 22 were females. 37 patients (group 1) has arterial hypertension (AH), 35 patients (group 2) has not AH. Before and 12 months after valve replacement patients underwent transthoracic echocardiography. Results: Mean (SD) age in group 1 was 67.9 ± 8.5 year, in group 2 – 59.3 ± 13.5 years. But the time from diagnosis to surgery was higher in group 2 – 22.6 ± 13.5 years vs 14.8 ± 8.6 years in group 1. As shown in table 1 patients with hypertension more often have degenerative valve lesion (60% vs 37%), while in group 2 more frequently observed bicuspid valve 16% vs 40% (p < 0.05). Also, in group 1 patients more often has CAD 43% vs 9% (p < 0.05) and permanent atrial fibrillation 26% vs 6% (p < 0.05). Despite this, the severity of heart failure was not exceed in the first group than the second. At baseline the size of the left chambers and thickness of left ventricular wall had not significant difference between groups (Table 2). At 12 months after surgery in patients without AH there was a significant (p < 0.05) decrease in the size of the left ventricle (LVESD) and in the wall thickness (IVST and LVPWT). Also ejection fraction increased in the 2 group (p < 0.05). In the first group all echocardioscopy parametres were unchanged during the 12 months period. Conclusions: Patients with arterial hypertension and aortic stenosis have greater comorbidity, but this does not affect the degree of heart failure. It was not observed significant difference in remodeling the left ventricle in normotensive and hypertensive patients with aortic stenosis before surgery. The absence of arterial hypertension positively affects on parameters of cardiac remodeling at patients with aortic stenosis 12 months after valve replacement.