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Specific characteristics of intracardiac hemodynamics and vegetative regulation in healthy young individuals with normal heart geometry and concentric remodeling of left ventricle.

OBJECTIVE
Introduction: Heart remodeling is a complex multifactor process determining the prognosis of the patient with any cardio-vascular pathology. There are convincing observations and conclusions in literature about the formation of concentric remodeling of LV prior to the appearance of any changes in AP [4, 5]. But until now there is no common point of view as to the factors involved in remodeling both the myocardium and the vessels, especially in the absence of the major known causative factor - arterial hypertension. From this perspective the study of relationship between cardiac and vascular remodeling as well as the factors involved in their development, especially in young individuals, is urgent. The aim of this work was a comparative study of characteristic features of intracardiac hemodynamics, daily profile of arterial pressure, daily ECG monitoring data and vegetative regulation in young apparently healthy individuals (18-44 years) with normal heart geometry and those with concentric remodeling of left ventricle.


PATIENTS AND METHODS
Materials and Methods: Apparently healthy persons aged 18 to 42 years, mean age 25.3±0.6 years, were included in the study. There were 56 males (73.7%) and 20 females (26.36%). All participants of the study were divided into two equal groups consisting of 38 persons according to relative wall thickness (RWT) value of the left ventricle: the patients with RWT > 0.42 (concentric remodeling of left ventricle) and those with RWT ≤ 0.42 (normal geometry of left ventricle).


RESULTS
Results and Conclusion: The analysis of obtained findings revealed comparatively larger sizes of left heart cavities, comparatively higher rate of AP morning rise and daily variability of predominantly systolic arterial pressure, decreased activity of parasympathetic nervous system, greater number of supraventricular premature beats mainly at night time as well as the signs of connective tissue dysplasia in the patients with concentric remodeling of left ventricle. More than half of young persons with concentric remodeling of left ventricle showed the signs of connective tissue heart dysplasia, namely prolapse of mitral valve and abnormal left ventricular chords. Those specific characteristics of heart structure, daily profile of arterial pressure and variability of cardiac rhythm can be considered the signs associated with concentric remodeling of left ventricle.


CONCLUSION