ВЗАИМОСВЯЗЬ АРТЕРИАЛЬНОЙ ЖЁСТКОСТИ С ПОКАЗАТЕЛЯМИ РЕМОДЕЛИРОВАНИЯ СЕРДЕЧ- НО-СОСУДИСТОЙ СИСТЕМЫ У БОЛЬНЫХ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ

The aim of the study was to study the indicators of local and regional stiffness of the vascular wall in correlation with the structural and functional parameters of cardiovascular remodeling in patients with arterial hypertension. Material and methods. The study included 151 patients with essential hypertension (EH) of the I – II stage (average age 55.4 ± 11.4 years, 41.7 % of men, average blood pressure 162/101 mm Hg). Echocardiography was performed using an En VisorC ultrasound system (PHILIPS, Holland) with a 3.5 MHz sensor in the patient’s position on the left side at an angle of 45 ° according to standard methods. Ultrasound scanning of the carotid arteries (general, external and internal) was performed using an En VisorC ultrasound system (PHILIPS, Holland) with a linear sensor with a frequency of 10 MHz in M-, B-, CDW- and PW-modes. Analysis of systemic and regional stiffness of the arterial bed was performed by applanation tonometry using a SphygmoCor (AtCor Medical, Australia). Statistical processing of the material was carried out using the licensed statistical software package SPSS for Windows version 7.0. The results of the study. When studying the average indices of local stiffness of the common carotid artery a general tendency in patients with EH was found to worsen most indicators of the elasticity of the vascular wall as the stage and degree increased of essential hypertension: Ep = 625.8 ± 24.9 mm Hg in patients with 1st stage of EH and Ep = 987.9 ± 34.9 mm Hg at 2nd stage of EH (p = 0.031). The correlation analysis revealed statistically significant negative relationships: the stiffness index with the size of the left atrium in the diastole (n = 151; r = –0.41; p = 0.013), the end-systolic size of left ventricle (LV) (n = 151; r = –0.44; p = 0.007) and the end-systolic volume of LV (n = 151; r = –0.44; p = 0.007). There was revealed an independent influence of the stiffness index on the end-diastolic volume of LV (r = 0.157, β = –0.004, p = 0.018) as a result of multiple regression analysis. Significant changes in arterial stiffness indicators were revealed depending on the thickness of the intimamedia complex in patients with arterial hypertension (extensibility and Peterson’s modulus of elasticity). As a result of the step-by-step method, only two predictors of arterial stiffness (the elastic modulus of Peterson and Jung) contributed to the dependent variable of the thickness of the intima-media complex in patients with EH. Conclusions. In the vast majority of patients with EH form concentric hypertrophy and concentric left ventricular myocardial remodeling. In men and women with hypertension, changes in LVMI indicate a high rate and intensity of LV hypertrophy, while in men, LVMI reaches maximum values. In addition, there was established a significant association of arterial stiffness with the thickness of the intima-media complex (total contribution was 91 %) and echocardiographic parameters characterizing the volumes of the left heart.