V. Tashchuk, H. Hrebtiy, Omer Muhammad Khuda Bakhsh, Aissaoui Anis

The study made it possible to identify the changes of structural and morphological, systolic-diastolic indices of the left ventricular remodeling and vascular endothelial function parameters in patients with hypertension and normal and high body mass and underweight patients. Endothelial function was studied with the use of samples with reactive hyperemia (endothelium-dependent vasodilation) and nitroglycerin (endothelium-independent vasodilation). Conventionally considered to be a normal reaction is a dilatation of the brachial artery in the case of reactive hyperemia of over 10,0 % of its diameter prior to the test, if it’s value is less or there is a vasoconstriction, it is considered to be pathological. In hypertensive patients with concomitant abdominal obesity the thickness of the interventricular septum and the posterior wall of the left ventricular, the end-systolic size and end-diastolic dimensions as well as the index of left ventricular mass were significantly bigger than in other groups of patients with hypertension, indicating the tendency to develop mainly concentric left ventricular hypertrophy.

The changes, detected by the transmitral blood flow analysis, have the same direction in all groups of patients and reflect the formation of the hypertrophic type of diastolic function disorder. However, the intergroup analysis of the diastolic function changes in patients with normal body mass and abdominal obesity showed that most violations of diastolic filling of the left ventricle occurs in patients with concomitant abdominal obesity.

Analysis of echocardiographic parameters in patients with deficiency of the body mass showed a tendency to form a concentric left ventricular hypertrophy and diastolic dysfunction of the first type. In patients with low body mass compared to a group of patients with satisfactory weight, there is a significantly smaller left ventricular mass, indicating a slightly lower level of left ventricular hypertrophy and decrease of the deceleration time of the early diastolic filling caused by an increase in myocardial stiffness, which adversely affects the contractility of the heart. In patients with third stage hypertension, according to the results of the study, there was observed a significant decrease in abnormal endothelium-dependent vasodilatation of the brachial artery and a decrease of its sensitivity to shift tension, regardless of body weight, although more pronounced in patients with underweight and in patients with the concomitant abdominal obesity. At the same time the endothelium-independent vasodilation in response to nitrates was preserved.