Russian Heart Failure Journal 2014year Features of structure and function myocardial remodeling in relation to the etiological cause of chronic heart failure


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2014/№6

Features of structure and function myocardial remodeling in relation to the etiological cause of chronic heart failure

Klester E.B., Plinokosova L.A., Lychev V.G., Klester K.V.
State Budgetary Educational Institution “Altay State Medical University” of the RF Ministry of Health Care, Prospekt Lenina 40, Barnaul, Altay Territory

Keywords: myocardial remodeling, chronic obstructive pulmonary disease, CHF, EchoCG


DOI: 10.18087 / rhfj.2014.6.1962

Background. In the Russian population, arterial hypertension (AH) is the major etiological factor of CHF (88 %) while CHF is induced by chronic obstructive pulmonary disease (COPD) in every tenth patient. At present, the contingent of patients with combined cardiorespiratory conditions is continuously growing. Aim. To perform a comparative study of major regularities in left and right heart remodeling during CHF development in patients with COPD and AH. Materials and methods. Comprehensive clinical observation was conducted on 163 patients including 55 patients with COPD (group I), 48 patients with COPD+AH (group II), and 60 patients with AH (group III). The inclusion criterion was the presence of CHF. In evaluation of gender distribution, the majority of patients were men (65–69 %). Mean age of group I patients was 61.5±0.67, group II – 63.4±0.39, and group III – 62.1±0.61. Patients of groups I and II had mild and moderate obstructive disease; patients of groups II and III mostly had grade II AH. Mean CHF FC was 2.2±0.06 in group I, 2.6±0.06 in group II, and 2.4±0.05 in group III (pI–II; pII–III <0.05). Results. LV EF was statistically significantly higher in patients of group I than group II. Systolic dysfunction (LV EF <45 %) was observed in 14.5 % of group I patients. In patients of group II, the rate of low LV EF was significantly higher, 31.3 % (c2=4.19; р=0.04). 35 (63.6 %) patients with COPD had type I diastolic dysfunction. In group II, 17 (35.4 %) patients had type 1 LV diastolic dysfunction; 21 (43.7 %) patients – type 2 (pseudonormal); and 11 (22.9 %) patients – type 3 transmitral flow spectrum. 78.3 % patients with AH had diastolic disorders of both LV and (to a lesser degree) right ventricle (RV). Conclusion. LV and RV remodeling processes were observed in groups I, II and III. The most pronounced increase in size and wall thickness, increase in LV myocardium mass, and decrease in LV pump function were observed in group II (patients with combined cardiovascular and respiratory disease).
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Klester E. B., Plinokosova L. A., Lychev V. G. et al. Features of structure and function myocardial remodeling in relation to the etiological cause of chronic heart failure. Russian Heart Failure Journal. 2014;15 (6):355–360

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