PECULIARITIES OF THE SYMPATHETIC FUNCTION IN ARTERIAL HYPERTENSION WITH DIFFERENT VARIANTS OF LEFT VENTRICLE REMODELING IN ITS HYPERTROPHY

Abstract

80 patients with essential hypertension were studied to evaluate the relationship between impaired sympathetic function and the way of LV remodeling in its hypertrophy. We measured daily catecholamines excretion, the degree of LV mass increase and the character of LV geometry alterations. We have found that in LVH with different ways of remodeling impairments in the sympathetic function were registered having common principles and peculiar features. In both excentric and concentric ways of LVH daily catecholamines excretion was observed to increase as LV mass grew, as well as the development of hormonal-mediator dissociation reaching its peak in marked LVH, and decreased reserve potential of catecholamines synthesis in significantly increased LV mass, as proved by decreased DOPA secretion. The peculiar feature of altered sympathetic function are different inclines in catecholamines excretion depending on the variant of LV remodeling. In the excentric variant we observed a pronounced activation of the mediator branch, appearing in early stages of increased LV mass and progressing alongside LVH. In concentric hypertrophy the hormonal branch was activated in early and marked LVH. The results point that the nature of sympathetic impairments in LVH depended on LV geometry rather than the increase of LV mass in patients with essential hypertension.