RESUMEN
23 patients with hypertrophic cardiomyopathy (HCMP) and 19 patients with stage II of essential hypertension (EH) with left ventricular asymmetric hypertrophy (ASH) were examined. Echocardiography demonstrated significantly more manifest hypertrophy of interventricular septum and higher coefficient of asymmetry in patients with HCMP compared to those with EH while left ventricular myocardium mass was equal in both groups. Phase-volumetric analysis exhibited in all the patients deterioration of myocardial relaxation processes. EKG-monitoring showed a significant increase in frequency of supraventricular rhythm disturbances in patients with HCMP while no reliable differences in total frequency of rhythm and conduction disturbances were registered. Regular adequate antihypertensive therapy resulted in patients with EH in decrease of ASH degree caused by regression of interventricular septum hypertrophy. In natural course of EH the ASH degree also decreased, but in this case because of increased hypertrophy of left ventricular posterior wall. The patients with HCMP were followed for 1-1.5 years. Drug therapy produced no significant changes in left ventricular myocardium mass as well as character of degree of ASH.
Asunto(s)
Cardiomegalia/patología , Cardiomiopatía Hipertrófica/complicaciones , Hipertensión/complicaciones , Contracción Miocárdica , Miocardio/patología , Adulto , Factores de Edad , Cardiomegalia/etiología , Cardiomegalia/fisiopatología , Ventrículos Cardíacos/fisiopatología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We examine the heart's involvement in arterial hypertension, reporting on several studies of hypertensive patients showing that left ventricular myocardial mass is a significant prognostic indicator of essential hypertension and that left ventricular hypertrophy (LVH) correlates with an induced increase in Ca2+ concentration in platelets. We also consider the LVH variant of asymmetric hypertrophy and the role of the hypertensive heart in coronary insufficiency, and we speculate on the significance of the degree of LVH and asymmetric hypertrophy as risk factors for predicting cardiac complications of essential hypertension.
Asunto(s)
Cardiomegalia/complicaciones , Hipertensión/complicaciones , Plaquetas/metabolismo , Calcio/metabolismo , Cardiomegalia/fisiopatología , Circulación Coronaria , Hemodinámica , Humanos , Hipertensión/fisiopatología , Pronóstico , Factores de RiesgoRESUMEN
The paper is concerned with an analysis of the effectiveness of the outpatient and hospital stages in the treatment of patients with essential hypertension with stable and high AP indices. The absence of significant changes in the time course of AP, the number and nature of complications and the number of days of temporary disability was shown in 197 patients treated in the groups of outpatient and outpatient-hospital therapy.
Asunto(s)
Atención Ambulatoria , Presión Sanguínea , Hospitalización , Hipertensión/terapia , Absentismo , Adulto , Enfermedad Crónica , Terapia Combinada , Estudios de Evaluación como Asunto , Humanos , Hipertensión/complicaciones , Hipertensión/fisiopatología , Persona de Mediana EdadRESUMEN
Changes in myocardial function and the possibility of a regression of left-ventricular hypertrophy were examined in patients with stable hypertension during a year of effective hypotensive treatment. Ninety-seven patients with essential hypertension, stage IIB (by Myasnikov's classification) and aged 35 to 56 years, were studied. Echography was conducted before the onset of treatment and after one year of regular hypotensive therapy. A marked hypotensive effect was noted in the course of treatment. Left-ventricular myocardial weight declined in 69% of patients, remained unchanged in 18.6% and increased in 12.4% despite the hypotensive effect of treatment. The reduction of left-ventricular hypertrophy was associated with no basic changes of myocardial pump function or contractility.
Asunto(s)
Antihipertensivos/uso terapéutico , Corazón/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Adulto , Atención Ambulatoria , Hemodinámica/efectos de los fármacos , Humanos , Hipertensión/patología , Hipertensión/fisiopatología , Persona de Mediana Edad , Contracción Miocárdica/efectos de los fármacos , Tamaño de los Órganos/efectos de los fármacos , Factores de TiempoRESUMEN
Different levels of water-salt metabolism control were studied in patients with stable essential hypertension (SEH). The sample was found to be highly heterogeneous in terms of the magnitude of the body's water-filled spaces in relation to plasma renin activity (PRA) and the cooking salt gustatory sensitivity threshold, examined in the presence of various salt diets and diuretic treatments. Three patterns of response to salt loads were identified in SEH patients with respect to sodium and water elimination by the kidneys: the first was identical to that of normal subjects, while the second one featured increased, and the third one, decreased, diuresis and natriuresis. Prostaglandin E2 and kallikrein were shown to be involved in the formation of the second- and third-type renal response to excessive salt. Differential treatment of EH patients with diuretics alone or, where necessary, in combinations with small-dose beta-blockers or vasodilators provides effective BP control for some 1.5 to 2 years in 65% of patients.