Dynamics of Structural – Functional State of the Left Ventricle in Patients with Hypertension and Chronic Ischemic Heart Disease on the Background of Gastroesophageal Reflux Disease Under the Influence of Antihypertensive and Antireflux Therapy

Diseases of the circulatory system are the most common pathology in Ukraine and cover 26,2 mln. Population 12,3 mln ukrainians suffer from hypertension (AH). Gastroesophageal reflux disease (GERD) is recognized by the World Organization of Gastroenterology disease of the XXI century. Given the common risk factors for hypertension coronary heart disease (CHD) and the question of GERD studies of the combined flow of these diseases and to optimize the treatment of these patients. The objective: to determine the characteristics of intracardiac hemodynamics in patients with hypertension combined with chronic ischemic heart disease on the background of GERD and the determination of the combined effects of antihypertensive and antireflux therapy on the structural-functional state of the left ventricular myocardium. Patients and methods. We examined 107 patients aged 44 to 78 years, with an established diagnosis of hypertension stage I and II in combination with chronic ischemic heart disease. Research methods included anthropometric studies, biochemical blood analysis, ambulatory blood pressure monitoring, the daily ECG monitoring, esophagogas-troduodenoscopy (EGD), echocardiography (echocardiography), testing. Results. Comorbidity for hypertension, chronic ischemic heart disease and GERD is associated with a higher frequency of abdominal type of obesity and the metabolic syndrome according to IDF criteria, significantly higher percentage of patients with grade II and III obesity. That in turn is reflected in the features of the structural1functional state of the left ventricle (LV), which manifests an increase in the number of patients with more severe degrees of left ventricular hypertrophy. Related GERD is associated with a large percentage of cases of concentric hypertrophy of the left ventricle, and a greater prevalence of diastolic dysfunction. The combination of antihypertensive and antireflux therapy for 12 weeks of treatment was reflected in the significant decrease in the weight of the index parameters of left ventricular myocardium (LVMI) and relative wall thickness index and reliable positive dynamics of indicators of left ventricular diastolic function. Conclusion. Patients with hypertension combined with chronic ischemic heart disease with comorbidity with GERD have a higher prevalence of factors of cardiovascular risk. Related GERD is associated with a more severe degree of left ventricular hypertrophy, with a large percentage of cases of concentric hypertrophy of the left ventricle, and a greater prevalence of diastolic dysfunction. A combination of antihypertensive and antireflux therapy for 12 weeks of treatment promoted significant reduction in myocardial mass index indicators LV (LVMI) and relative wall thickness index and had a significant impact on the normalization of LV diastolic function