Sokolova M. The role of myocardial deformation imaging in the assessment of left heart chambers and treatment of hypertensive postmenopausal women

The thesis is devoted to the improvement of the pathological changes of left heart chambers’ diagnostics and optimization of postmenopausal hypertensive women’s treatment by the studying of myocardial deformation. To achieve this aim 100 women with uncomplicated arterial hypertension (AH) and physiological or surgical menopause, who formed the main group (mean age 57.7 ± 4.3 years) in an open prospective controlled study, were enrolled. 26 normotensive women with physiological menopause (mean age 56.2 ± 3.5 years, p>0.05) formed a control group. All participants of the study were undergone a general clinical examination, ambulatory blood pressure monitoring (ABPM), duplex scan of carotid arteries, standard transthoracic and speckle-tracking echocardiography, as well as laboratory determination of the main biochemical parameters, markers of cardiac remodeling cardiotrophin-1 (CT-1) and ST2, and female reproductive hormones. According to the results of standard transthoracic echocardiography, the patients of the main group had significantly greater thickness of the interventricular septum (IVS) by 23.4 % (р<0.01), the posterior wall of the left ventricle (PWLV) by 16.27 % (р<0.01) and the myocardial mass index of the LV (MMILV) by 17,78 % (p<0.01). Pathological increase in LV relative wall thickness (RWT) > 0.42 was observed in a significantly higher proportion of patients with AH than among normotensive women: in 71 % and 38.5 % of persons respectively (χ2 = 20,53; p<0,0001). As a consequence, concentric types of LV remodeling observed significantly more often in postmenopausal patients with AH than in healthy subjects: in 71 % and 38.5 % cases, respectively (χ2 = 9.52; p <0.01). The prolonged increase in blood pressure (BP) contributed to the development of left atrial (LA) dilation in 47% of patients of the main group, when all women of the control group had normal linear and volumetric parameters of LA.