Relationship of cardiac and carotid arteries remodeling in women with arterial hypertension

Purpose. Nowadays information about significance of different types of vascular remodeling and their interrelation with hypertensive heart development is scarce. Aim. To assess separate changes in carotid intima and media thickness and their interrelations with heart remodeling in women with arterial hypertension. Materials and methods. 95 female (to avoid sex difference) patients with AH I – II degree without any additional risk factors ( disease duration 2 – 16 yrs ) with the average age 47,6 ± 7,4 yrs have been examined. 36 apparently healthy women ( the average age 44,0 ± 8,3 yrs ) have formed the control group. The carotid IMT has been measured by LOGIC P5 PRO, GE (B-regime) using ZOOM function (at the level 1 cm aside from the bifurcation area following the standard procedure); simultaneously the intima thickness (as hyperechogenic stripe and according to its echogenicity which corresponds to surrounding tissues of the vessel) and the media thickness (as hypoechogenic stripe which is located under intima and its echogenicity corresponds to the vessel lumen) have been measured separately. Simultaneously all significant heart indexes: posterior wall thickness (PWT), interventricular septum thickness (IVST) in diastole, left atrial dimension (LA), end-systolic (ESD), end-diastolic dimensions (EDD), end-diastolic (EDV) and end-systolic volume (ESV), left ventricular mass index (LVMI) and ejection fraction (EF) were measured and estimated. Statistical methods included Spearman's rank correlation, statistically significant at p value < 0.05. Results and discussion. Between media of the carotid arteries and PWT (R = 0,295, p <0.003), as well as with LVMI (R = 0,322, p <0.001) was fixed direct correlation, which is characterized by greater power and the level of statistical significance, than with the intimal layer. Also a direct correlation between the media and performance EDD (R = 0,289, p = 0.004), EDV (R = 0,289, p = 0.004), ESD (R = 0,339, p = 0.0008), ESV (R = 0,339 , p = 0.0008) and IVST (R = 0,258, p = 0.003), which may indicate the role of LV systolic function in the formation of hypertensive heart. Direct correlation between inner diameter of the carotid arteries and ESD, EDD, PWT, IVST, EDV, ESV, LVMI (R от 0,250 до 0,458, р < 0,05) and inverse relationship with EF (r = -0,467; р = 0,001) has been established. Conclusions: Cardio - vascular remodeling in AH is associated not only with traditional common intima – media thickness but more tightly with separate media thickness and inner vessel diameter of large arteries enlargement. Significant and reliable negative relationship between media thickening, inner diameter of carotid arteries index and left ventricle EF has been established; it may indicate new peculiarities of the initial impact of vascular remodeling onLV systolic dysfunction development