Kursina N. Features of structural and functional changes of myocardium of Chernobyl accident clean-up workers with essential arterial hypertension after irradiation in the low doses range and the effect of antihypertensive therapy on the regression of changes

The dissertation is dedicated to research of features of left ventricular hypertrophy (LVH) of the hearts of Chernobyl accident (ChA) clean-up workers (CW) with arterial hypertension (EH), the importance of radiation and non-radiation factors and their interaction in development and progress of LVH, regression of LVH and associated changes. It was proved that the development of LVH in ChA CW occurs at an earlier age under the interaction of long load pressure with radiation and non-radiation factors with the mutual increase of their dangerous effect. A direct correlation was found between the thickness and weight of the myocardium and external radiation dose 25-60 cSv, excretion rates of catecholamines, the highest integral score of negative reminiscences of the events of the Chernobyl accident. LVH for ChA CW associated with greater frequency and severity of diastolic dysfunction, duration of ischemia per day, frequency of ventricular extrasystoles. Myocardial mass index was proved to correlate with threshold power, duration of loading, volume of work performed, which were significantly lower than of the non-irradiated patients. Background regression and treatment in LVH were determined. It is shown that only long-term use of blockers of renin-angiotensin-aldosterone system using combination therapy provides a reliable reduction in weight and thickness of the myocardium at least 10% per year. The results can be used in medical practice to optimize early diagnosis, monitoring and treatment of LVH of ChA CW with essential hypertension, in expert advice in determining cardiac pathology due to participation in eliminating the aftermath of the Chernobyl accident.