LEFT VENTRICULAR REMODELING IN HYPERTENSION: EVOLUTION OF THE APPROACH

Abstract

Left ventricular remodeling is one of the earliest complications of hypertension that has been proven to be an independent predictor of cardiovascular morbidity and mortality. In this article, the development of approaches to understanding its mechanics and prognostic value are briefly reviewed, with additional focus on patients with obesity and type 2 diabetes mellitus as frequent comorbid pathologies that significantly modify the typical morphological changes of the heart in hypertension. The main intacardiac mechanisms of decrease of left ventricular function constituing the direct pathophysiological and pathomorphological base for development of chronic heart failure are presented.

KeyWords:  hypertension, left ventricle, remodeling, dysfunction, chronic heart failure.

 

РЕМОДЕЛЮВАННЯ ЛІВОГО ШЛУНОЧКА У ХВОРИХ НА ГІПЕРТОНІЧНУ ХВОРОБУ:  ЕВОЛЮЦІЯ УЯВЛЕНЬ

Ащеулова Т.В., Гончарь О.В., Смирнова В.І., Герасимчук Н.М., Іванченко С.В.

Ремоделювання лівого шлуночка є одним із найранніших ускладнень гіпертонічної хвороби та має доведену незалежну цінність в якості предиктора серцево-судинної захворюваності та смертності. У статті наведено короткий історичний огляд розвитку уявлень про механізми та прогностичну цінність різних варіантів ремоделювання лівого шлуночка з додатковим фокусом на пацієнтах із супутнім ожирінням та цукровим діабетом 2 типу як частими коморбідним станами, що у значній мірі модифікують типові морфологічні зміни серця при артеріальній гіпертензії. Висвітлено основні інтракардіальні механізми порушення функціональної спроможності лівого шлуночка, що становлять безпосереднє патофізіологічне та патоморфологічне підгрунтя розвитку синдрому хронічної серцевої недостатності при гіпертонічній хворобі.

Ключові слова: артеріальна гіпертензія, лівий шлуночок, ремоделювання, дисфункція, хронічна серцева недостатність.

 

РЕМОДЕЛИРОВАНИЕ ЛЕВОГО ЖЕЛУДОЧКА У БОЛЬНЫХ ГИПЕРТОНИЧЕСКОЙ БОЛЕЗНЬЮ: ЭВОЛЮЦИЯ ПРЕДСТАВЛЕНИЙ

Ащеулова Т.В., Гончарь А.В., Смирнова В.И., Герасимчук Н.Н., Иванченко С.В.

Ремоделирование левого желудочка является одним из наиболее ранних осложнений гипертонической болезни и имеет доказанную независимую ценность в качестве предиктора сердечно-сосудистой заболеваемости и смертности. В статье приведен краткий исторический обзор развития представлений о механизмах и прогностической ценности разных вариантов ремоделирования левого желудочка с дополнительным фокусом на пациентах с сопутствующим ожирением и сахарным диабетом 2 типа как частыми коморбидным состояниями, в значительной степени модифицирующими типичные морфологические изменения сердца при артериальной гипертензии. Освещены основные интракардиальные механизмы нарушения функциональной состоятельности левого желудочка, что представляющие собой непосредственное патофизиологическое и патоморфологическое основание развития синдрома хронической сердечной недостаточности при гипертонической болезни.

Ключевые слова: артериальная гипертензия, левый желудочек, ремоделирования, дисфункция, хроническая сердечная недостаточность.

https://doi.org/10.35339/ic.4.4.167-172
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