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A0703 The influence of antecedent arterial hypertension on possible heart failure development in patients with acute myocardial infarction

Objectives: To determine the changes of functional heart parameters (FHP) and brain natriuretic peptide (BNP) levels in patients with acute myocardial infarction (AMI) and antecedent hypertension (AH). Methods: 35 hypertensive patients (duration of AH 9.8 + 3.7 years) and 31 normotensive patients with their first AMI were examined. Groups were comparable in age and gender. Cardiac ultrasound was done to all patients on 3rd and 28th day after AMI. BNP levels were assessed 64 ± 7 hours after onset of chest symptoms. Results: Patients of the hypertensive group had the following dynamics of FHP from 3rd to 28th day: left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) showed a tendency to increase (+ 4.1%; 63.82 ± 5.13 mm; +13.9%; 58.16 ± 6.73 mm, respectively) as well as the ejection fraction (EF) +12.8%; 44.85 ± 2.93%, (p ≥ 0.05). Normotensive group: a decrease of LVEDV was observed (−15.3%; 52.75 ± 4.23 mm; p = 0.027), as well as LVESV (−19.7%; 38.64 ± 3.48 mm; p = 0.031); EF increased to 23% (49.53 ± 2.76%; p = 0.008). The analysis of indexes on 28th day showed increase of EF in both groups (68.85 % and 85.66% of patients respectively, p = 0.039); the decrease of contractile ability was determined in 25.2% and 14.29% of patients respectively, p = 0.034). Patients with AMI and AH demonstrated higher levels of BNP compared to controls (812.46 pg/ml vs 487.68 pg/ml, p ⩽ 0.05). Also, a positive correlation was found between BNP and LVEDV (r = 0.319, p ⩽ 0.05), BNP and peak troponin levels (r = 0.406, p ⩽ 0.05). Conclusion: Significantly higher levels of BNP and worse dynamics of FHP in patients with AMI and AH suggest increased probability of the left ventricle dysfunction, heart failure development and poorer prognosis than in patients with AMI without past history of hypertension.