Niconova V. Clinical and haemodynamic variants of heart remodeling for the juveniles with primary arterial hypertension.

Object of the study:juveniles with primary arterial hypertension. Purpose of the study: to improve methods of early diagnostics of heart remodeling for the juveniles with primary arterial hypertension (PAH) on the grounds of studying of morphological and functional myocardium state, clinical and haemodynamic indices and vegetative state. Methods of the investigation: roentgenography, electrocardiography, echocardiography; biochemical examination: blood plasma renin and aldosteron, urinary adrenalin and noradrenalin, blood serum lipids, peroxide oxidation of lipids, antiozidative protection. Theoretical and practical results: receive results allow recommend in clinical examination juvenileswith PAH obligatory echocardiography for reveal early singes heart remodeling. Determined various types of cardiovascular sistem remodeling demand different methods of therapy. Novelty: At juveniles at the PAH forming stages were discovered four types of remodeling of left ventricular (LV): first - normal geometry ofLV when adequacy of blood circulation is provided by myocardium's functional resources increasing in response to bloodstream's involving into process; second - left ventricular hypertrophy accompanied by development of myocardium's diastolic dysfunction against a background of normokinetic type of blood circulation; third - dilatation of LV developing mainly as a result of a dysplasia of connective tissue, when compensation of hemodynamics arises from hyperkinetic variant of blood circulation; fourth - combination of interventricular septum (IS) hypertrophy with the dilatation of LV arising as a result of acute form of hyperkinesias with unequal reaction of vascular tone. It was found that together with heart's left part remodeling also occur changes in its right part. Various types of heart remodeling for the juveniles wiyh PAH be accompanied violation neurohumoral and biochemical index. Degree of introduction: The results of the work were introduced in the work of functional diagnosis office emergency hospital (Kharkiv), central hospital N 5 (Kharkiv), Institute of general and emergency surgery (Kharkiv), district children's hospital (Poltava), district children's hospital N 1 (Kharkiv), of the work cardiology and functional diagnosis chair KMAPS. Sphere of application: Medicine, cardiology, pediatry.