Interrelation of cognitive impairments and structural and functional features of the left ventricle of the heart in patients with hypertension
Journal Title: Український терапевтичний журнал - Year 2018, Vol 0, Issue 3
Abstract
Objective — to study morphofunctional changes in the left ventricle in patients with arterial hypertension with cognitive impairment. Materials and methods. Examinations involved 76 patients with stage II arterial hypertension, and 12 practically healthy persons aged (51.55 ± 0.86) and (54.25 ± 2.74) years, respectively. To assess cognitive function, the Montreal Evaluation Scale (MoCA-test) was used. Patients were divided into 2 groups: the first included 40 subjects without cognitive impairment, the second group consisted from 36 patients with cognitive impairment (according to the MoCA-test). The structural and functional state of the heart was investigated based on the echocardiography data with evaluation of cardiac contractile function with method of speckle tracking echocardiography. Results and discussion. In all patients with arterial hypertension, regardless of the presence of cognitive impairment, the structural and functional parameters of the left ventricular myocardium according to echocardiography significantly differed from those of the control group. All patients had a preserved ejection fraction (60 ± 2.4) and (58 ± 3.2) % and left ventricular hypertrophy. There were no significant differences between the groups in the studied parameters in patients with arterial hypertension. The correlation between the expression of the left ventricular myocardial mass index and the sum of the MOCA-test scores in patients with arterial hypertension with cognitive impairment (r = – 0.31, p < 0.05) was revealed. According to speckle tracking echocardiography longitudinal deformation of the left ventricle in patients with arterial hypertension was reduced by 60 % of patients of the 1st group and by 91.7 % of patients of the second group and significantly differed both in the intergroup comparison and with the control group. A correlation was found between the index of the total longitudinal deformation of the left ventricle and the presence of cognitive impairment (r = – 0.44, p < 0.01). Conclusions. Decrease in the left ventricular function in the longitudinal direction is associated with cognitive impairment in patients with grade II and III arterial hypertension in addition to the presence of the left ventricular hypertrophy. The use of speckle tracking echocardiography can help in the early detection of subclinical systolic dysfunction of the left ventricle in patients with hypertension with a higher risk of developing cognitive impairment.
Authors and Affiliations
О. V. Molodan, S. S. Boev, M. Ya. Dotsenko, I. O. Shekhunova, L. V. Gerasimenko, O. Ya. Malynovska, V. O. Ivashchuk
Keywords
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- EP ID EP457104
- DOI 10.30978/UTJ2018-3-4-34
- Views 69
- Downloads 0
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