Damage to the heart under essential hypertension manifests a combination of changes in the left ventricle, left atrium, and coronary arteries resulted from a chronic elevation in blood pressure. Hypertension increases the load on the heart, causing structural and functional changes in the myocardium. Associations between clinical, laboratory and instrumental indicators and the levels of various biomarkers, which characterize the specificity and severity of systemic processes occurring in the cardiovascular system and can also be used for predicting the prognosis of diseases, are of undoubted practical interest. The aim of this study was to research the associations between the structural and functional state of the myocardium and the levels of serum NT-proBNP and ST2 in hypertensive patients with / without chronic coronary disease. Materials and methods. 118 patients with stage II hypertension with / without chronic coronary disease were included in the study. For all patients, both the main indicators of the structural and functional state of the myocardium according to echocardiography and serum levels of NT-proBNP and ST2 were additionally measured on the 2-3rd day of hospital stay when optimal therapy was being selected. Results. The obtained data indicate that a relatively low level of NT-proBNP is associated with a significant increase in the size of the right atrium and the right atrial index and the frequency of cases with concentric hypertrophy of the left ventricle compared to intermediate and relatively high levels of the neurohormone. The patients with relatively low neurohormone level demonstrate a significant increase in end-diastolic size and left atrial size compared with only intermediate levels. The results of the analysis of changes in echocardiogram indicators depending on the level of ST2 in plasma demonstrate the complete absence of any reliable changes between the selected groups.

Annotation. The article presents the results of the study of the relationship between the quality of life of patients with arterial hypertension (AH) and atrial fibrillation (AF) with serum levels of the N-terminal fragment of brain natriuretic propeptide (NT-proBNP) and the suppressor of tumorigenicity 2 (ST2). As part of an open observational randomized comparative study, 89 patients with stage II AH and various clinical forms of AF were examined. All patients underwent a general clinical examination, additional determination of levels of serum NT-proBNP and ST2 biomarkers, and assessment of quality of life according to the SF-36 and MLHFQ questionnaires on the 2-3 day stay in the hospital against the background of selection of optimal therapy. Statistical analysis was performed using Microsoft Excel (2016) and Statistica 12.0 (Statsoft, USA). The average value of the indicator, standard deviation was determined using one-way ANOVA & LSD test, Spearman's rank correlation analysis was used. According to the results of the study, there was a certain association of deterioration of the quality of life of patients with AH and AF with an increase in levels of serum NT-proBNP and ST2. It was demonstrated that a relatively high level of serum NT-proBNP was associated with impaired role functioning, determined by physical and emotional state according to the SF-36 scale, and impaired quality of life according to the MLHFQ. In addition, there was a direct correlation (R=0.41; p<0.0001) between actual levels of serum NT-proBNP and the total MLHFQ score. A relatively high level of serum ST2 was associated with a significant decrease in physical functioning, vitality, social functioning, role functioning due to emotional state, physical and mental health components, and an increase in pain intensity according to the SF-36, as well as a significant deterioration of the quality of life according to the MLHFQ. In addition, there was an inverse correlation (R=-0.36, p<0.0001) between actual levels of serum ST2 and the value of the physical component of health according to the SF-36 and a positive relationship (R=0.48, p<0.0001) with the value of the total score according to the MLHFQ.

The article presents the results of studying the variability of the level of soluble growth stimulating factor expressed by gene 2 (sST2) in plasma in patients with hypertension depending on various clinical characteristics. An open observational one-point randomized comparative study included 118 patients with stage II hypertension. The main group included 89 patients with stage II hypertension and various clinical forms of atrial fibrillation. The comparison group included 29 patients with stage II hypertension without atrial fibrillation. All patients underwent a general clinical examination. In addition, plasma levels of sST2 were determined. In accordance with the aim and objectives of the study, plasma levels of sST2 were analyzed depending on the clinical characteristics of the patients, the main risk factors and the nature of the damage to the target organs. The calculation of different levels of the biomarker was carried out, followed by the selection of groups with a relatively low, intermediate and relatively high level of sST2. In the course of the study, it was determined that in patients with atrial fibrillation, a significantly higher level of sST2 is observed in paroxysmal and permanent compared to persistent form of arrhythmia. A significant correlation (p<0.01) between the content of sST2 in plasma and the severity of the clinical course of arrhythmia, determined by the EHRA (European Heart Rhythm Association) class, has been proven. In addition, in patients with stage II hypertension with/without atrial fibrillation, increased plasma levels of sST2 are associated with the presence of concomitant chronic coronary disease, the functional class of chronic heart failure according to the NYHA (New York Heart Association) and the presence of such factors risk as pulse arterial pressure >60 mm Hg and type II diabetes. Keywords: chronic coronary disease; chronic heart failure; stimulating growth factor expressed by gene 2; variability of the sST2 level.

Annotation. The article presents the results of studying the variability of the level of the N-terminal fragment of brain natriuretic propeptide (NT-proBNP) in plasma in patients with hypertension with/and without chronic coronary disease. An open observational one-point randomized comparative study included 118 patients with stage II hypertension with/and without chronic coronary disease (stable angina pectoris I-III functional class). An additional criterion for inclusion in the main group was the presence of atrial fibrillation. All patients, in addition to general clinical examination, additionally determined the levels of NT-proBNP in the blood plasma. Statistical processing of the obtained data was carried out using Microsoft Excel (2016) and Statistica 12.0 (Statsoft, USA). Absolute values were presented as the average value of the indicator (Mean) ± standard deviation for the sample (SD, standard deviation). Comparison of mean values in groups was performed using one-way ANOVA & LSD test. The dependence of the NT-proBNP level on the duration of the hypertensive history, the value of the functional classes of angina pectoris of chronic heart failure was proven. At the same time, it was demonstrated the lack of interdependence of the level of this biomarker with the clinical variant of atrial fibrillation and its characteristics, such as the duration of the history, ENRA class and frequency of attacks. The fact of a decrease in the level of NT-proBNP in the plasma in the case of alimentary-constitutional obesity and an increase in the body mass index was confirmed. In addition, an increase in the level of this biomarker was observed in the case of presence of hypertrophy of the left ventricle according to the ECG data, as well as in the case of a decrease in the value of the glomerular filtration rate, calculated according to the CKD-EPI formula.

Background. Hypertension and atrial fibrillation are a fairly common combination of heart pathology that occurs in the daily practice of a cardiologist. Associations of clinical laboratory and instrumental indicators with the levels of various biomarkers, in particular serum N-terminal fragment of brain natriuretic propeptide (NT-proBNP), are interesting and promising for scientific research and practical application. The aim of the study was to simulate the clinical profiles of patients with hypertension and atrial fibrillation depending on the serum levels of NTpro-BNP. Materials & Methods. 89 patients with stage II hypertension and various clinical forms of atrial fibrillation were included in the study. All patients underwent a general clinical examination, additional determination of NT-proBNP serum levels, and assessment of quality of life according to the Minnesota Living with Heart Failure Questionnaire (MLHFQ) for 2–3 days of hospital stay at against the background of selection of optimal therapy. Sequential statistical processing of the obtained data using Spearman’s rank correlation analysis and multiple linear regression made it possible to create two clinical profiles of patients. Results & conclusions. Thus, with a relatively high serum level of NTpro-BNP (≥810 ng/l), the following will be characteristic: hypertensive history >12 years; the presence of signs of left ventricular hypertrophy on the ECG according to the Sokolov-Lyon criteria; increase in the right atrium >36 mm and systolic pressure in the pulmonary artery >38 mm Hg according to Echocardiography; an increase in the average daily heart rate >110 per 1 min with Holter ECG monitoring; a decrease in the glomerular filtration rate <56 ml/min/1.73m2 and an increase in the total MLHFQ score >27. The dominant markers of a relatively high level of NTpro-BNP were a decrease in quality of life, instrumental signs of hemodynamic overload of the right heart and clinically significant cardiorenal disorders. With a relatively low serum level of NTpro-BNP (≤220 ng/l), the following will be characteristic: hypertensive history anamnesis <8 years; lack of signs of the left ventricle hypertrophy on the ECG according to the Sokolov-Lyon criteria; the size of the right atrium <34 mm and/or the value of systolic pressure in the pulmonary artery <33 mm Hg according to Echocardiography; average daily heart rate with Holter ECG monitoring <92 per 1 minute; glomerular filtration rate >68 ml/min/1.73m2 and the total MLHFQ score <21. The dominant markers of a relatively low level of NTpro-BNP were the absence of signs of left ventricular hypertrophy on the ECG and a balanced state of sympatho-adrenal activity by the nature of circadian regulation of heart rate. Keywords: atrial fibrillation; N-terminal fragment of brain natriuretic propeptide; clinical profile of patients.