ABSTRACT
AIM: to study laboratory parameters of endothelial dysfunction (ED) and their correlation with risk factors (RF) of cardiovascular diseases at early stages of essential arterial hypertension (AH) in adolescents. MATERIAL AND METHODS: We examined 299 adolescents aged 12-18 years with EAH. According to results of 24-hour blood pressure (BP) monitoring all patients were divided into three groups: (1) 98 adolescents with "white coat hypertension", (2) 108 adolescents with liable AH (LAH), (3) 93 patients with stable AH (stAH). Control group consisted of 27 healthy adolescents. Examination included 24-hour BP monitoring, measurement of some laboratory parameters of ED (Von Willebrand factor [vWF], nitric oxide metabolites, urine catecholamines), and assessment of cardiovascular RF. RESULTS: Mean vWF values in groups (2) and (3) were clinically significantly different from control. Increase of vWF activity by 1 unit was associated with increase of mean nocturnal pulse pressure by 0.36 mm Hg (p = 0.048). Markers of ED were related to family history of AH, overweight and low birth weight.
Subject(s)
Blood Pressure/physiology , Endothelium, Vascular/physiopathology , Hypertension/physiopathology , Vasodilation/physiology , Adolescent , Blood Pressure Monitoring, Ambulatory , Child , Disease Progression , Essential Hypertension , Female , Follow-Up Studies , Humans , Hypertension/blood , Hypertension/diagnosis , Male , Nitric Oxide/blood , Retrospective StudiesABSTRACT
We studied geometric changes of the left heart in 299 teenagers aged 12-18 years with essential arterial hypertension (EAH). According to 24-hour blood pressure monitoring all patients were divided into three groups: patients with phenomenon of "white coat hypertension" (WCH, n=98); patients with labile arterial hypertension (LAH, n=108); patients with stable atrial hypertension (SAH, n=93). Control group comprised 27 healthy adolescents. Parameters of central hemodynamics were assessed by echocardiography. Geometric left ventricular (LV) changes were found in 69 (23.1%) teenagers with EAH. Risk of formation of eccentric LV hypertrophy in teenagers with SAH was significantly higher than in subjects with WCH and LAH. Pulse pressure made significant contribution to formation of LV hypertrophy. Excess weight contributed significantly to formation of structural and geometric changes of LV and left atrium.
Subject(s)
Heart Ventricles/physiopathology , Hypertension/physiopathology , Ventricular Function, Left/physiology , Ventricular Remodeling , Adolescent , Child , Disease Progression , Echocardiography , Female , Heart Ventricles/diagnostic imaging , Humans , Hypertension/complications , Hypertension/diagnostic imaging , Hypertrophy, Left Ventricular/diagnostic imaging , Hypertrophy, Left Ventricular/etiology , Hypertrophy, Left Ventricular/physiopathology , Male , PrognosisABSTRACT
AIM: To assess influence of 2-week course therapy with atenolol, nebivolol, and verapamil on systolic and diastolic left ventricular function and mammary coronary blood flow in early period after revascularization. MATERIAL: Patients (n=113) after mammary coronary bypass grafting. METHODS: Echocardiographic characteristics of systolic and diastolic left ventricular function, and blood flow through mammary coronary grafts were measured before and after treatment with study drugs. RESULTS: In placebo treated patients isovolumic relaxation time (IVRT) and late diastolic filling phase (A) increased, while velocity characteristics of mammary-coronary blood flow decreased. Administration of atenolol, nebivolol, and verapamil was associated with significant increases of left ventricular ejection fraction, stroke volume, cardiac output, IVRT, peak diastolic velocity, flow through mammary coronary grafts and their lumen diameter, and decrease of E/A ratio. CONCLUSION: Administration of atenolol, nebivolol, and verapamil in early postoperative period after mammary coronary bypass grafting improved systolic and diastolic function of the left ventricle, and blood flow through mammary coronary grafts. None of the studied drugs had significant advantage over others.
Subject(s)
Coronary Artery Bypass , Diastole , Diastole/drug effects , Hemodynamics , Humans , Stroke Volume/drug effects , SystoleABSTRACT
In our previous studies we demonstrated possibility of the use of stress echocardiography with sublingual administration of nitroglycerine for detection of viable myocardium. Basing on data about myocardial and cerebrovascular reserves obtained during nitroglycerine tests we created mathematical model for prediction of hemodynamic effectiveness of coronary bypass surgery. Stress echocardiography, Doppler echography of middle cerebral and internal carotid arteries with nitroglycerine were carried out in 80 patients with coronary artery disease before myocardial revascularization. Quantitative equivalent characterizing degree of myocardial reserve preservation in early postoperative period was used as basis for discrimination of patients into groups with positive and negative result of surgery, and coefficients and constants of discriminant function were calculated for these groups. According to results of clinical testing sensitivity, specificity and diagnostic effectiveness of the model were 76.9, 75 and 76%, respectively.
