Russian Heart Failure Journal 2013year Remodeling of the left ventricle in female patients with surgical menopause


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2013/№1

Remodeling of the left ventricle in female patients with surgical menopause

Pustotina Z. М., Lareva N. V.

Keywords: myocardial remodeling, sergical menopause

DOI: 10.18087 / rhfj.2013.1.1779

Relevance. Despite intensive studies of cardiovascular disorders in female patients with surgical menopause, remodeling LV has been poorly studied. Objective. Study pathogenetic particularities of LV remodeling in female patients with surgical menopause depending on microcirculation disorders. Materials and methods. 99 female patients in surgical menopause were enrolled to the study: Group 1–46 patients (45.9±3.5 years) after hysterectomy with ovarian tissue preserved, Group 2–31 patients (46.1±3.1 years) after bilateral ovariectomy, Group 3–22 patients (46.0±3.6 years), taking substitutive hormonotherapy (SHT). In the control group, 25 healthy women at the age of 45±3.6 with preserved menstrual function were examined. Patients underwent EchoCG examination, 24hour BP monitoring, and microcirculation examination by laser doppler flowmetry. Results. In female patients with posthysterectomic syndrome and preserved ovarian tissue, LV normal geometry (LVNG) was detected in half cases, LV concentric remodeling (LVCR) – one in three patients (32.6 %), LV concentric hypertrophy (LVCH) (13 %) and excentric hypertrophy (LVEH) (4.3 %) was observed considerably more rarely. In the group of patients with surgical menopause and removed ovaries, only one in five patients (19.4 %) had no LV architectonics disorders, 32.2 % patients had LVCH, 38.7 % – LVCR, LVEH was the rarest (9.6 %). In the group of patients taking SHT, LV geometry war more often normal (72.7 %), in 5 (22.7 %) patients LVCR was revealed, and only in 1 (4.5 %) – LVCH. It was established that LVCH developed significantly more often in hypertensive patients, LVNG was more often in normotensive patients. In the group of non-hypertensive patients, LV remodeling was observed in 46.5 % of cases. Analysis of LV geometric models depending on microcirculation disorders showed that patients with impaired microcirculation (pathologic types of microcirculation) had LV remodeling significantly more often (78.2 %), and patients with normocirculatory type if microcirculation – LVNG (68.2 %). Conclusion. In 49.9 % patients with posthysterectomic syndrome and 80.6 % patients after bilateral ovariectomy, LV remodeling was revealed. LV architectonics disorders were observed in patients with and without hypertension and depended on presence of microcirculatory disorders. SHT promotes LVNG preservation.
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Pustotina Z. М., Lareva N. V. Remodeling of the left ventricle in female patients with surgical menopause. Russian Heart Failure Journal. 2013;14 (1):29-33

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