How to Cite
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.
References
Mancia, Giuseppe, Fagard, Robert, Narkiewicz, Krzysztof, Redon, Josep, Zanchetti, Alberto, Böhm, Michael, . . . Wood, David A. (2013). 2013 ESH/ESC guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European Heart Journal, 34(28), 2159-2219. doi: 10.1093/eurheartj/eht151
Cepeda-Valery, Beatriz, Pressman, Gregg S., Figueredo, Vincent M., & Romero-Corral, Abel. (2011). Impact of obesity on total and cardiovascular mortality—fat or fiction? Nature Reviews Cardiology, 8(4), 233-237. doi: 10.1038/nrcardio.2010.209Agabiti-Rosei, Enrico, Muiesan, Maria Lorenza, & Salvetti, Massimo. (2006). Evaluation of subclinical target organ damage for risk assessment and treatment in the hypertensive patients: left ventricular hypertrophy. Journal of the American Society of Nephrology : JASN, 17(4 Suppl 2), S104-108. doi: 10.1681/ASN.2005121336
Gottdiener, John S., Reda, Domenic J., Materson, Barry J., Massie, Barry M., Notargiacomo, Alpo, Hamburger, Robert J., . . . Henderson, William G. (1994). Importance of obesity, race and age to the cardiac structural and functional effects of hypertension. Journal of the American College of Cardiology, 24(6), 1492-1498. doi: 10.1016/0735-1097(94)90145-7
Ganau, Antonello, Devereux, Richard B., Roman, Mary J., de Simone, Giovanni, Pickering, Thomas G., Saba, Pier Sergio, . . . Laragh, John H. (1992). Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. Journal of the American College of Cardiology, 19(7), 1550-1558. doi: 10.1016/0735-1097(92)90617-V
Strauer, B. E. (1987). Structural and functional adaptation of the chronically overloaded heart in arterial hypertension. American Heart Journal, 114(4 PART 2), 948-957. doi: 10.1016/0002-8703(87)90592-8
Shlyakhto, Ye.V., & Konradi, A.O. (2002). Role of genetic factors in remodeling of cardiovascular system in essential hypertension [in Russian]. Arterial Hypertension, 4(3), 22-29.
Agabiti-Rosei, Enrico, Muiesan, Maria Lorenza, & Salvetti, Massimo. (2006). Evaluation of subclinical target organ damage for risk assessment and treatment in the hypertensive patients: left ventricular hypertrophy. Journal of the American Society of Nephrology : JASN, 17(4 Suppl 2), S104-108. doi: 10.1681/ASN.2005121336
Campus, S., Malavasi, A., & Ganau, A. (1987) Systolic function of the hypertrofied left ventricle. J Clin Hypertens, 3, 79-87.
De Simone, Giovanni, Di Lorenzo, Luigi, Moccia, Domenico, Costantino, Guido, Buonissimo, Salvatore, & De Divitiis, Oreste. (1987). Hemodynamic hypertrophied left ventricular patterns in systemic hypertension. The American Journal of Cardiology, 60(16), 1317-1321. doi: 10.1016/0002-9149(87)90614-X
Devereux, R. B., & Roman, M. J. (1999). Left ventricular hypertrophy in hypertension: stimuli, patterns, and consequences. Hypertension Research: Official Journal of the Japanese Society of Hypertension, 22(1), 1-9. doi: 10.1291/hypres.22.1
Rieznik, L.A. (2011). Left ventricular remodeling in patients with hypertension and type 2 diabetes mellitus [in Ukrainian]. Problems of Continuous Medical Education and Science, 4, 70-75.
Eguchi, Kazuo, Kario, Kazuomi, Hoshide, Satoshi, Ishikawa, Joji, Morinari, Masato, & Shimada, Kazuyuki. (2005). Type 2 diabetes is associated with left ventricular concentric remodeling in hypertensive patients. American Journal of Hypertension, 18(1), 23-29. doi: 10.1016/j.amjhyper.2004.08.024
Khrebtiy, G.I. (2009). Structural and functional remodeling of the left ventricle, intracardiac hemodynamics and vascular endothelial function in patients with essential hypertension and obesity [in Ukrainian]. Bukovynskyi medychnyi visnyk, 13(1), 79-82.
Vakili, B. A., Okin, P. M., & Devereux, R. B. (2001). Prognostic implications of left ventricular hypertrophy. American heart journal, 141(3), 334-341. doi: 10.1067/mhj.2001.113218
Krumholz, Harlan M., Larson, Martin, & Levy, Daniel. (1995). Prognosis of left ventricular geometric patterns in the Framingham heart study. Journal of the American College of Cardiology, 25(4), 879-884. doi: 10.1016/0735-1097(94)00473-4
Ponikowski, Piotr, Voors, Adriaan A., Anker, Stefan D., Bueno, Héctor, Cleland, John G. F., Coats, Andrew J. S., . . . Van Der Meer, Peter. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 37(27), 2129-2200m. doi: 10.1093/eurheartj/ehw128
Galderisi, Maurizio. (2005). Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects. Cardiovascular Ultrasound, 3(1), 9-9. doi: 10.1186/1476-7120-3-9
Hein, Stefan, Arnon, Eyal, Kostin, Sawa, Schönburg, Markus, Elsässer, Albrecht, Polyakova, Victoria, . . . Schaper, Jutta. (2003). Progression from compensated hypertrophy to failure in the pressure-overloaded human: Heart structural deterioration and compensatory mechanisms. Circulation, 107(7), 984-991. doi: 10.1161/01.CIR.0000051865.66123.B7
Mueller, Thomas, Dieplinger, Benjamin, Gegenhuber, Alfons, Poelz, Werner, Pacher, Richard, & Haltmayer, Meinhard. (2008). Increased plasma concentrations of soluble ST2 are predictive for 1-year mortality in patients with acute destabilized heart failure. Clinical Chemistry, 54(4), 752-756. doi: 10.1373/clinchem.2007.096560
Blaufarb, I.S. (1996). The renin-angiotensin system in left ventricular remodeling. American Journal of Cardiology, 77(13), 8C-16C.
Galis, Zorina S., & Khatri, Jaikirshan J. (2002). Matrix metalloproteinases in vascular remodeling and atherogenesis: the good, the bad, and the ugly. Circulation research, 90(3), 251-262. doi: 10.1161/hh0302.105345
Spinale, F. G. (2007). Myocardial Matrix Remodeling and the Matrix Metalloproteinases: Influence on Cardiac Form and Function. Physiological Reviews, 87(4), 1285-1342. doi: 10.1152/physrev.00012.2007
Spinale, F. G., Ishihra, K., Zile, M., DeFryte, G., Crawford, F. A., & Carabello, B. A. (1993). Structural basis for changes in left ventricular function and geometry because of chronic mitral regurgitation and after correction of volume overload. The Journal of thoracic and cardiovascular surgery, 106(6), 1147-1157.
Kuwahara, Fumitaka, Kai, Hisashi, Tokuda, Keisuke, Takeya, Motohiro, Takeshita, Akira, Egashira, Kensuke, & Imaizumi, Tsutomu. (2004). Hypertensive Myocardial Fibrosis and Diastolic Dysfunction: Another Model of Inflammation? Hypertension, 43(4), 739-745. doi: 10.1161/01.HYP.0000118584.33350.7d
"Inter Collegas" is an open access journal: all articles are published in open access without an embargo period, under the terms of the CC BY-NC-SA (Creative Commons Attribution ‒ Noncommercial ‒ Share Alike) license; the content is available to all readers without registration from the moment of its publication. Electronic copies of the archive of journals are placed in the repositories of the KhNMU and V.I. Vernadsky National Library of Ukraine.
Copyright Agreement
1. This Agreement on the transfer of rights to use the work from the Co-authors to the publisher (hereinafter the Agreement) is concluded between all the Co-authors of the work, represented by the Corresponding Author, and Kharkiv National Medical University (hereinafter the University), represented by an authorized representative of the Editorial Board of scientific journals (hereinafter the Editorial Board).
2. This Agreement is an accession agreement within the meaning of clause 1 of Article 634 of the Civil Code of Ukraine: that is, a contract, "the terms of which are established by one of the parties in forms or other standard forms, which can be concluded only by joining the other party to the proposed contract as a whole. The other party cannot offer its terms of the contract." The party that established the terms of this contract is the University.
3. If there is more than one author, the authors choose the Corresponding Author, who communicates with the Editorial Board on his own behalf and on behalf of all Co-authors regarding the publication of a written work of a scientific nature (article or review, hereinafter referred to as the Work).
4. The contract begins from the moment of submission of the manuscript of the Work by the Corresponding Author to the Editorial Board, which confirms the following:
4.1. all Co-authors of the Work are familiar with and agree with its content, at all stages of reviewing and editing the manuscript and the existence of the published Work;
4.2. all Co-authors of the Work are familiar with and agree to the terms of this Agreement.
5. The published Work is in electronic form in public access on the websites of the University and any websites and electronic databases in which the Work is posted by the University and is available to readers under the terms of the "Creative Commons" license (Attribution NonCommercial Sharealike 4.0 International)" or more free licenses "Creative Commons 4.0".
6. The Corresponding Author transfers, and the University receives, the non-exclusive property right to use the Work by placing the latter on the University's websites for the entire term of copyright. The University participates in the creation of the final version of the Work by reviewing and editing the manuscript of the article or review provided to the Editorial Board by the Corresponding Author, translating the Work into any languages. For the participation of the University in the finalization of the Work, the Co-authors agree to pay the invoice issued to them by the University, if such payment is provided by the University. The size and procedure of such payment are not the subject of this contract.
7. The University has the right to reproduce the Work or its parts in electronic and printed forms, to make copies, permanent archival storage of the Work, distribution of the Work on the Internet, repositories, scientometric databases, commercial networks, including for monetary compensation from third parties.
8. The co-authors guarantee that the manuscript of the Work does not use works whose copyright belongs to third parties.
9. The authors of the Work guarantee that at the time of submission of the manuscript of the Work to the Editorial Board, the property rights to the Work belong only to them, neither in whole nor in part have they been transferred to anyone (not alienated), they are not the subject of a lien, litigation or claims by third parties.
10. The Work may not be posted on the University's website if it violates a person's right to the privacy of his personal and family life, harms public order and health.
11. The work may be withdrawn by the Editorial Board from the University websites, libraries and electronic databases where it was placed by the Editorial Board, in cases of detection of violations of the ethics of the authors and researchers, without any compensation for the losses of the Co-authors. At the time of submission of the manuscript to the Editorial Board and all stages of its editing and review, the manuscript must not have already been published or submitted to other editorial offices.
12. The right transferred under this Agreement extends to the territory of Ukraine and foreign countries.
13. The rights of Co-authors include the requirement to indicate their names on all copies of the Work or during any public use or public mention of the Work; the requirement to preserve the integrity of the Work; legal opposition to any distortion or other encroachment on the Work, which may harm the honor and reputation of the Co-authors.
14. Co-authors have the right to control their personal non-property rights by familiarizing themselves with the text (content) and form of the Work before its publication on the University's website, when transferring it to a printing company for reproduction or when using the Work in other ways.
15. The Co-authors, in addition to the property rights not transferred under this Agreement and taking into account the non-exclusive nature of the rights transferred under this Agreement, retain the property rights to finalize the Work and to use certain parts of the Work in other works created by the Co-authors.
16. The Co-authors are obliged to notify the Editorial Board of all errors in the Work, discovered by them independently after the publication of the Work, and to take all measures to eliminate such errors as soon as possible.
17. The University undertakes to indicate the names of the Co-authors on all copies of the Work during any public use of the Work. The list of Co-authors may be shortened according to the rules for the formation of bibliographic descriptions determined by the University or third parties.
18. The University undertakes not to violate the integrity of the Work, to agree with the Corresponding Author on all changes made to the Work during processing and editing.
19. In case of violation of their obligations under this Agreement, its parties bear the responsibility defined by this Agreement and the current legislation of Ukraine. All disputes under the Agreement are resolved through negotiations, and if the negotiations do not resolve the dispute – in the courts of the city of Kharkiv.
20. The parties are not responsible for the violation of their obligations under this Agreement, if it occurred through no fault of theirs. The party is considered innocent if it proves that it has taken all measures dependent on it for the proper fulfillment of the obligation.
21. The Co-authors are responsible for the truthfulness of the facts, quotes, references to legislative and regulatory acts, other official documentation, the scientific validity of the Work, all types of responsibility to third parties who have claimed their rights to the Work. The co-authors reimburse the University for all costs caused by claims of third parties for infringement of copyright and other rights to the Work, as well as additional material costs related to the elimination of identified defects.