Tovma A. Improvement of diagnosis and prediction of the development of left ventricular remodeling in adolescents with primary hypertension

The thesis is devoted to improving diagnosis and prediction of the development of left ventricular remodeling in adolescents with primary hypertension based on the study of blood pressure through office and ambulatory blood pressure measurements, electrophysiological, structural and functional state of the myocardium, molecular genetic research and quality of life self-assessment. The prognostic value of the ECG index Sokolow-Lyon at the time of diagnosis of primary hypertension in adolescents in the development of LV hypertrophy 6-12 months before its clinical proved. It was revealed that a decrease in the quality of life in adolescents with primary hypertension is determined by the TT genotype rs11665469 of the NFATC1 gene. An association of the C rs7240256 allele of the NFATC1 gene with an increased level of systolic blood pressure, as well as of the G allele rs2229309 of the NFATC4 gene with development left ventricular remodeling, was established. The predictors of the development of left ventricular remodeling were determined at the time of the diagnosis of hypertension: thickness of the posterior wall of the left ventricle >8.0 mm, average daily pulse BP >57 mm Hg and a body mass index >25 kg/m2.