Parameters Of Cardiovascular Remodeling Research Articles

Dynamics of testosterone and prolactin levels, blood pressure and parameters of cardiovascular remodeling in hypertensive men with androgen deficiency in the course of treatment

Numerous previous and up-to-date guidelines for antihypertensive treatment do not highlight the problem of interrelations between sexual dysfunction and hypertension itself or with the use of frequently prescribed medications. Changes in testosterone and prolactin concentrations in men undergoing antihypertensive treatment are still not well described.The aim of the study was to investigate the impact of combined antihypertensive treatment with the addition of phenibut on testosterone and prolactin concentrations, blood pressure and parameters of cardiovascular remodeling in hypertensive men with androgen deficiency.Materials and methods. A total of 113 men with stage II essential hypertension were recruited to participate in the study. All patients were subjected to routine clinical examination, evaluation of total (TT), free testosterone (FT) and prolactin using ELISA, 24-hour blood pressure monitoring (24-hour BPM), assessment of central aortic pressure and arterial stiffness, transthoracic echocardiography. All study subjects were prescribed the combined antihypertensive treatment with irbesartan and nifedipine. Depending on treatment scheme, all patients were divided into four groups: group 1A consisted of men with low TT who received phenibut in addition to antihypertensive treatment, group 1B – patients with androgen deficiency on antihypertensive treatment only, group 2A – patients with normal TT with the addition of phenibut, group 2B – men with normal TT on antihypertensive medications only.Results. As a result of prescribed treatment, TT and FT levels increased with discordant changes in the concentration of prolactin: a statistically significant increase in TT (29.72 %, P = 0.0002) and FT (28.08 %, P = 0.0003) with a significant decrease in prolactin concentrations (10.68 %, P = 0.008) were in the group 1A. All patients had positive 24-hour BPM dynamics, parameters of central aortic pressure and cardiovascular remodeling. Patients with androgen deficiency with the addition of phenibut had the highest reduction rates in 24-hour BPM values, central SBP, DBP, PBP, mean BP, augmentation index, RWTT, pulse pressure amplification, CAVIa and were characterized by significant improvement of longitudinal LV deformation and diastolic function.Conclusions. The use of combined antihypertensive therapy with irbesartan and nifedipine with the addition of phenibut in men with androgen deficiency contributes to the achievement of target blood pressure levels and improvement of cardiovascular remodeling parameters.

Features of cardiovascular remodeling, the level of neurohumoral factors depending on the degree of chronic heart failure and kidney dysfunction

Aim. To study the relationship between the level of the N-terminal prohormone of brain natriuretic peptide (NTproBNP) and aldosterone in serum, cardiovascular remodeling parameters with the degree of chronic heart failure (CHF) and kidney dysfunction (KD).Material and methods. Fifty two patients with coronary artery disease with CHF of I (19 patients), II (21) and III (12) functional classes (FC) were examined. All patients underwent echocardiography with assessment of systolic function and structural-geometric parameters of the left ventricle (LV), blood flow study at the level of the common carotid artery (CCA) with the determination of the thickness of the intim-media complex, velocity parameters of blood flow, resistance (RI) and pulsation (PI) indexes, estimated glomerular filtration rate (eGFR) by CKD-ЕРI method, the level of NTproBNP and aldosterone in serum. The patients were divided depending on the eGFR elvel: 30< eGFR ≤60 ml/min/1,73 m2 — 14 patients, eGFR >60 ml/min/1,73 m2 — 38 patients.Results. Patients with II FC CHF had the medium-high NTproBNP and aldosterone values. Subjects with FC III CHF had high levels of NTproBNP and aldosterone. A correlation relationship was found between the NTproBNP, aldosterone and ejection fraction (EF) levels (r=-0,70 and r=-0,72, respectively), between the NTproBNP, aldosterone and enddiastolic LV velocity (r=0,78 and r=0,70, respectively). There was a significant thickening of the carotid intima-media complex and a decrease in the blood flow velocity and an increase in vascular resistance with increasing CHF. We also noted a significant difference in the maximum end-diastolic velocity in patients with eGFR ≤60 ml/min/1,73 m2 compared with this indicator in patients with eGFR >60 ml/min/1,73 m2.Conclusion. In patients with CHF, a significant increase in NTproBNP and aldosterone levels is associated with FC of CHF, LV systolic dysfunction and KD. The interrelation of cardiovascular remodeling indicators with the degree of CHF and KD was revealed.

Abdominal visceral adipose tissue ultrasound assessmet as a tool in predicting of high cardiometric risk obesity

Objective: to conduct the analysis of association abdominal visceral adipose tissue ultrasound indices with parameters of cardiovascular remodeling and metabolic risk factors with subsequent evaluation of their use as a predictor of high cardiometabolic risk obesity. Material and methods. Totally, 274 normotensive males investigated (mean age 44.8±5.0 y. o.), with no clinical signs of cardiovascular disorders and type 2 diabetes, with the SCORE risk

The impact of obesity on the parameters of cardiovascular remodeling, cerebral blood flow and autonomic regulation of cardiac rhythm in hypertensive patients

Objective. The aim of this study was to assess autonomic regulation disturbances, disorders of systemic, brain and intra-cardiac hemodynamics and to find out the features of vascular and cardiac remodeling in patients with arterial hypertension associated with obesity. Materials and Methods. The study involved 82 patients with stage II hypertension combined with obesity (39 men and 43 women) and 18 (12 men and 6 women) patients with essential hypertension with normal body weight. All the patients underwent general clinical examination, ECG Holter monitoring with heart rate variability analysis, 24h ABPM, duplex echocardiography and pulsed-wave Doppler of extracranial vessels. Results. Patients with essential hypertension associated with obesity have significantly higher average daily SBP by 9.4 % (p = 0.036), average DBP by 12.1 % (p = 0.027) and hypertension time index by 83.3 % (p = 0.012), diastolic size of LA by 11.1 % (p = 0.007), IVSTd by 23.7 % (p = 0.001), LVMI by 14.3 % (p = 0.022) and reduced volume-mass index of LV by 18.8 % (p = 0.013). In patients with essential hypertension with obesity we observed a significant decrease in Vmax in the left CCA by 16.5 % (p = 0.003) and in the right CCA by 12.6 % (p = 0.046), Vmean in the left CCA by 16.8 % (p = 0.001) and in the right CCA by 14.4 % (p = 0.009), reduced Vmax by 19.1 % (p = 0.002) and Vmean by 21.9% (p = 0.002) in the right ICA. Levels of Vmax and Vmean in the left MCA in hypertensive patients with obesity were lower by 10.2% (p = 0.043) and 12.5 % (p = 0.044), while the index of vascular reactivity sensitive to hypercapnia in the left MCA was lower by 14.6 % (p = 0.015). In overweighed patients with hypertension the linear Vmax in the left VA was lower by 13.9 % (p = 0.015) and Vmean 14.5 % (p = 0.013), in the right VA Vmax and Vmean were lower by 17.7 % (p = 0.011) and 25.8 % (p = 0.003). In group with hypertension and obesity Vmean in BA showed a reduction by 17.3 % (p = 0.021), and index of reactivity sensitive to hypercapnia by 23.1 % (p = 0.002). Hypertensive patients with obesity and with normal body weight did not differ by temporal and spectral parameters of HRV. Index LF/HF in both groups exceeded 2 cu. Conclusions. The presence of obesity in patients with essential hypertension is accompanied by significantly higher average SBP and DBP, daily hypertension time index according to 24h ABPM, a significant increase in diastolic LA size, IVSTd, LVMI and decrease of LV volume-mass index, decreased blood flow in CCA, right ICA, left MCA, both VA and BA, index of vascular reactivity sensitive to hypercapnia in the left MCA and BA. In patients with essential hypertension regardless of whether obese or of normal body weight sympathetic part of the autonomic nervous system prevails.

Research of the features of cardiovascular remodeling and bone tissue metabolism markers changes in women with coronary artery disease, associated with postmenopausal osteoporosis

The coronary artery disease is the one of most urgent problems of modern cardiology as well as the problem of osteoporosis. The aim of research was to study the features of cardiovascular remodeling and bone tissue metabolism markers changes in women with coronary artery disease, associated with postmenopause osteoporosis.Methods of research. There were examined 78 women in postmenopause period with coronary artery disease (CAD): 1 group (comparison) – 19 women with CAD and normal indices of the bone tissue mineral density (BTMD); 2 group – 27 women with CAD and osteopenia; 3 group – 32 women with CAD and osteoporosis; the control group – 12 conventionally healthy women of corresponding age. With the help of ultrasound densitometry, echocardioscopy and immune-enzyme analysis the state of bone tissue mineral density, structural-functional state of heart and level of bone remodeling biomarkers were studied.Results. It was revealed, that CAD clinical course on the background of osteopenic syndrome is characterized with rise of bone remodeling markers level, increase of carotid arteries intima-media thickness, more often development of diastolic dysfunction, calcification of heart valves and big vessels, the correlations between the osteoprotegerin, osteocalcin, homocysteine levels and cardiovascular remodeling parameters were established.Conclusions. For women in postmenopause period with coronary artery disease, comorbid with osteoporosis is typical the rise of bone metabolism markers (osteoprotegerin, osteocalcin) levels and endothelial dysfunction (homocysteine) that not only reflect the state of bone tissue but also take part in cardiovascular remodeling

Description of cardiovascular remodeling parameters and osteopontin plasma level in dynamics of the candesartan therapy in patients with chronic kidney disease on the stage before dialysis

Aim. To examine the cardiovascular remodeling parameters and osteopontin plasma level in dynamics of the candesartan therapy in patients with chronic kidney disease on the stage before dialysis Methods and results. Peculiarities of the cardiovascular remodeling were studied in 52 patients with chronic kidney disease III, IV, and V stage. Echocardiography, carotid dopplerography, and immunoassay detection of the osteopontin level were done. The predominant type of pathological left ventricular geometry was concentric hypertrophy, its prevalence increased with worsening of the renal function. The maximum level of IMT was observed at stage V of the CKD. The chronic kidney disease progression was accompanied by increased plasma levels of the osteopontin. Conclusion. Direct correlation between the concentration of the protein and the index of left ventricular mass and the intima-media thickness were detected. The therapy with candesartan during 12 weeks leads to the significant reduction of osteopontin, which can be considered as a marker of cardiovascular remodeling in patients with CKD.

Biomarkers of Cardiovascular Remodeling in Patients on Peritoneal Dialysis

Objectives: The purpose of this study was to determine endothelin (ET)-1 and nitric oxide (NO) serum concentration levels at baseline and after 1 year of peritoneal dialysis (PD) treatment. A further aim was to evaluate the association between ET-1 and NO with parameters of echocardiography and the common carotid artery (CCA) ultrasound, and to assess their impact on cardiovascular remodeling. We also aimed to evaluate the influence of dialysis adequacy and residual renal function (RRF) on cardiovascular remodeling. Methods: This study included 40 PD patients in whom we measured serum ET-1 and NO concentrations, echocardiography and CCA ultrasound parameters. Results: ET-1 decreased and NO serum concentration levels increased (p < 0.01) after 12 months of PD treatment compared to baseline values. Left ventricular (LV) hypertrophy was observed in 77.5% of patients at baseline with significant reduction in LV mass index (LVMI), CCA intima media thickness (IMT) and plaque score after 12 months of PD treatment (p < 0.001). The dialysis adequacy and RRF were significantly associated with LVMI and CCA IMT after 12 months on PD. Conclusion: In our study, ET-1 significantly decreased while NO increased during PD treatment and both were independently related to the cardiovascular remodeling parameters in PD patients.

PLEIOTROPIC EFFECTS OF THE BONE METABOLISM MODULATOR - STRONTIUM RANELATE IN TREATMENT OF WOMEN WITH THE POSTMENOPAUSAL OSTEOPOROSIS AND ARTERIAL HYPERTENSION.

The trial was aimed at studying the effects of the modulator of bone metabolism - strontium ranelate on the parameters of cardiovascular remodeling in women with postmenopausal osteoporosis (OP) and arterial hypertension (AH). This effect includes the results of study of strontium ranelate in 48 women with postmenopausal osteoporosis AH 1-2 degrees and moderate or high cardiovascular risk. During 36 weeks 25 patients, in addition to antihypertensive therapy and calcium supplementation received strontium ranelate (Bivalos) 2 g / day. Bone mineral density (BMD) was evaluated by dual energy X-ray absorptiometry. The effect of strontium ranelate treatment on the thickness of the intima-media of the carotid artery (IMT) by the method of duplex scanning on structural and functional parameters of the heart by echocardiography also evaluated. Adding of strontium ranelate to the antihypertensive treatment and calcium supplementation in women with postmenopausal OP and AH has a positive effect on central hemodynamics, cardiovascular remodeling and diastolic filling.

Effects of Angiotensin II Type 1 Receptor Blocker on Blood Pressure Variability and Cardiovascular Remodeling in Hypertensive Patients on Chronic Peritoneal Dialysis

Aims: In this study, we examined whether addition of an angiotensin II type 1 receptor blocker (ARB), candesartan or valsartan, to conventional antihypertensive treatment could improve blood pressure (BP) variability in hypertensive patients on peritoneal dialysis. Methods: 45 hypertensive patients on chronic peritoneal dialysis therapy were randomly assigned to the ARB treatment groups either by candesartan (n = 15) or valsartan (n = 15), or the control group (n = 15). At baseline and 6 months after the treatment, 24-hour ambulatory BP monitoring, echocardiography, and measurement of brachial-ankle pulse wave velocity (baPWV) were performed. Results: After the 6 months of treatment, 24-hour ambulatory BP values were similarly decreased in both the control group and ARB groups. However, short-term BP variability assessed on the basis of the standard deviation of 24-hour ambulatory BP was significantly decreased in the ARB groups, but remained unchanged in the control group. Furthermore, parameters of cardiovascular remodeling assessed by natriuretic peptides, echocardiography, and baPWV were significantly improved in the ARB groups but not in the control group. Conclusion: ARB treatment and control antihypertensive treatment similarly controlled 24-hour ambulatory BP values in hypertensive patients on peritoneal dialysis. However, ARB treatment is beneficial for the suppression of pathological cardiovascular remodeling with a decrease in BP variability.

RAMIPRIL EFFICACY IN PATIENTS WITH ARTERIAL HYPERTENSION AND ISCHEMIC HEART DISEASE

Aim. To study ramipril effect on parameters of ambulatory blood pressure (BP) monitoring, cardio-vascular remodeling parameters in patients with arterial hypertension (HT) and ischemic heart disease (IHD). Material and methods. 40 patients with HT (stage 1-2) combined with IHD (functional class 1-2) were included in the study. All patients were randomized in 2 groups. Patients of the 1st group received basic therapy with aspirin, statin and ß-blocker. Patients of the 2nd group received the same therapy as well as ACE inhibitor ramipril (Hartil, EGIS). Changes in clinical status, daily BP profile, cardio-vascular remodeling parameters were evaluated. Results. After 12 week treatment clinical improvement was revealed in the both groups of the patients. Ramipril contributed additional pulse BP and BP loading reduction, regression of left ventricular hypertrophy, improvement of systolic and diastolic left ventricle function, increase in brachial artery diameter. Conclusion. Ramipril inclusion in the basic therapy of patients with HT and IHD increases in efficacy of antihypertensive treatment and improves structural and functional conditions of heart and vessels.