[Myocardial hypertrophy and coronary insufficiency as a cause of arrhythmia in patients with hypertension]. / Gipertrofiia miokarda i koronarnaia nedostatochnost' kak prichina narusheniia ritma u bol'nykh gipertonicheskoi bolezn'iu.

AIM: To elucidate contribution of left ventricular hypertrophy (LVH) vs myocardial ischemia to rhythmic disorders in patients with essential hypertension (EH) and LVH. MATERIALS AND METHODS: Echocardiography, coronarography, treadmill test, 24-h ECG monitoring were included in examination of 69, 69, 68 and 63 patients, respectively. All of them had EH stage II and LVH. The comparison was made between the groups composed by LVH degree and by the presence or absence of coronary artery atherosclerosis (CAA). RESULTS: Subjective arrhythmia was recorded in 27% of the examinees, while objective one was registered by 24-h monitoring and treadmill test in 85.7 and 42.6% of the patients, respectively. Ventricular arrhythmia in EH stage II patients with LVH is associated for the most part with coronary insufficiency, often in the presence of atherosclerosis of the coronary artery. High-grade ventricular extrasystoles by B. Lown and M. Wolf and LVH degree were related. CONCLUSION: An essential role in the onset of supraventricular arrhythmia (SVA) in EH stage 2 patients with LVH belongs to the size of the left atrium and LVH degree. SVA is related to left ventricular myocardial ischemia.

[The prognosis of the disease course in patients with hypertension and coronary failure]. / O prognoze techeniia zabolevaniia u bol'nykh gipertonicheskoi bolezn'iu s koronarnoi nedostatochnost'iu.

The analysis of 3-year follow-up and treatment of 33 and 113 hypertensive subjects without and with coronary insufficiency, respectively, suggested the conclusion on an independent role of left ventricular hypertrophy as a risk factor of cardiac complications in hypertensive patients either with or without coronary insufficiency. A high risk of cardial complications can be expected in hypertensive patients without coronary insufficiency, but with systolic pressure above 200 mm Hg, thickness of the left ventricular posterior wall more than 1.3 cm, % delta S under 40. In the presence of coronary insufficiency hypertensive subjects have a high risk of the complications in case of stroke output over 50 ml, sigma max over 340 10(3) din/cm2, left ventricular myocardial mass over 220 g, history of myocardial infarction. No significant correlation was found between arterial pressure reduction due to antihypertensive treatment and development of cardial complications.

[HLA antigens in hypertension patients with myocardial hypertrophy of the left ventricle]. / Antigeny HLA u bol'nykh gipertonicheskoi bolezn'iu s gipertrofiei miokarda levogo zheludochka.

As many as 34 patients with essential hypertension (EH) and 66 with hypertrophic cardiomyopathy (HCMP) were examined. Concentric hypertrophy of the myocardium was identified in 14 patients with EH and 35 patients with HCMP. Asymmetric hypertrophy of the myocardium was diagnosed in 20 EH patients and 31 HCMP patients. Distribution of class I and II HLA antigens was examined in all the patients. The high rate of DR1 antigen demonstration was established in patients with associated EH and asymmetric hypertrophy of the myocardium. The patients with associated HCMP and hypertrophy of the myocardium showed the high rate of B40 and DR4 antigen demonstration, those with associated HCMP and asymmetric hypertrophy of the myocardium the high rate of DR1 and DR4 antigen demonstration. The data obtained may be of importance for the formation of the groups at risk for the development of the diseases in question and for their differential diagnosis in doubtful cases.

[Comparative aspects of the structural and functional status of the myocardium in left-ventricular asymmetrical myocardial hypertrophy in patients with hypertension and cardiomyopathy]. / Sravnitel'nye aspekty strukturno-funktsional'nogo sostoianiia miokarda pri asimmetricheskoi gipertrofii miokarda levogo zheludochka u bol'nykh gipertonicheskoi bolezn'iu i gipertroficheskoi kardiomiopatiei.

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.