CORRELATION BETWEEN THE CHANGES IN HYPERTROPHIC GEOMETRIC MODELS OF THE LEFT VENTRICLE AND CLINICAL, ANTHROPOMETRIC, METABOLIC-HORMONAL PARAMETERS, AND MINERAL METABOLISM INDICATORS

K. Voroniuk
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Abstract

Objective: to analyze the correlation between the changes in hypertrophic geometric patterns of the left ventricle and the changes in metabolic-hormonal parameters and indicators of mineral metabolism depending on the allelic state of the AGT (rs4762) and GNB3 genes in patients with essential arterial hypertension (EAH). Material and methods. The case-control study involved 100 patients with EAH stage II, 1–3 degrees of blood pressure (BP) elevation, high and very high cardiovascular risk. Among the patients, there were 21% (21) men and 79% (79) women. The mean age of patients was 59.86 ± 6.22y.o. The control group consisted of 60 apparently healthy individuals, matched on age (49.13 ± 6.28y.o.) and gender distribution (63% women, 37% men). The lipid panel parameters were measured in blood plasma, including TC (total cholesterol), ТG (triglycerides), LDL-C (low-density lipoprotein cholesterol), HDL-C (high-density lipoprotein cholesterol). All subjects were tested for serum levels of fasting glucose, ionized calcium, parathyroid (PTH) hormone, 25-hydroxyvitamin D (Vit D). Left ventricular hypertrophy (LVH) and LVH models were examined by echocardiography. Clinical and anthropometric examination methods were used in the study. Results. Eccentric left ventricular hypertrophy (ELVH) in patients with EAH was associated with higher blood pressure than concentric left ventricular hypertrophy (CLVH): systolic blood pressure and diastolic blood pressure were higher by 3.29% and 3.95%, respectively (р ≤ 0.05–0.04). ELHV was associated with higher body mass index and waist circumference (WC) in women – by 7.80% and 7.40% (р ≤ 0.05–0.048), respectively. In addition, the ELVH development was characterized by a lower level of ionized Ca2+ in the blood vs. CLVH (by 2.54%, р = 0.021), while the concentration of PTH in a compensatory manner was higher by 23.86% (р = 0.047), which indicated the calcium homeostasis intensity in EAH patients. The lipids, glucose serum concentration and Vit D level were not associated with any hypertrophic model of myocardium. Conclusions. Lipid profile, blood glucose, and Vit D concentration did not determine the development of any type of the LVH. ELVH was associated with a lower level of Ca2+ and consequently an elevated level of PTH. The formation of ELVH in patients with EAH was accompanied by a higher level of blood pressure and was also associated with higher BMI and WC.
左心室肥厚几何模型变化与临床、人体测量、代谢激素参数和矿物质代谢指标的相关性
目的:分析原发性动脉性高血压(EAH)患者左心室肥厚几何形态变化与AGT (rs4762)和GNB3基因等位基因状态下代谢激素参数及矿物质代谢指标变化的相关性。材料和方法。病例对照研究纳入100例EAH II期患者,血压升高1-3度,心血管风险高和极高。其中男性21例,占21%;女性79例,占79%。患者平均年龄59.86±6.22岁。对照组为60例明显健康个体,年龄(49.13±6.28岁)、性别分布(女性63%,男性37%)相匹配。测定血浆脂质面板参数,包括TC(总胆固醇)、ТG(甘油三酯)、LDL-C(低密度脂蛋白胆固醇)、HDL-C(高密度脂蛋白胆固醇)。所有受试者均检测空腹血糖、游离钙、甲状旁腺激素(PTH)、25-羟基维生素D (Vit D)水平,超声心动图检查左室肥厚(LVH)及左室肥厚模型。研究采用了临床和人体测量的方法。EAH患者偏心性左室肥厚(ELVH)患者血压高于同心性左室肥厚(CLVH)患者:收缩压和舒张压分别高3.29%和3.95% (p < 0.05 ~ 0.04)。ELHV与女性较高的身体质量指数和腰围(WC)相关,分别为7.80%和7.40% (r≤0.05-0.048)。此外,与CLVH相比,ELVH发展的特点是血液中离子Ca2+水平较低(2.54%,r = 0.021),而PTH浓度以代偿方式升高23.86% (r = 0.047),这表明EAH患者钙稳态强度较高。血脂、血糖、血清Vit D水平与心肌肥厚模型均无相关性。血脂、血糖和Vit D浓度不能决定任何类型LVH的发展。ELVH与Ca2+水平较低相关,因此PTH水平升高。EAH患者ELVH的形成伴随着较高的血压水平,也与较高的BMI和WC相关。
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