Microcirculation conditions and its influence on ventricular remodeling in patients with arterial hypertension and lower extremity arteries atherosclerosis

Abstract

Objective: to evaluate the feature of microcirculation condition and left ventricle remodulation type in patients with arterial hypertension (AH) and lower extremity arteries atherosclerosis (LEAA).Materials and methods: one hundred patients from 45 to 65 years old were included in this research. The main group consisted of 50 patients with arterial hypertension and lower extremity arteries atherosclerosis and the control group included 50 patients with AH and without LEAA. Laser doppler flowmetry and echocardiography were performed for all patients.Results: there were lower values of microcirculation index (26,54[10,51–29,25] vs 37,3[26,59–40,24], р=0,0001), Am (0,25[0,22–0,32] vs 0,36[0,35–0,48], р=0,001) и Аe (0,47[0,42–0,47] vs 0,50[0,50–0,58], р=0,001), capillary reserve (134,5[126,7–151,8] vs 166,4[153,2–166,4], р=0,001). Breathe test index (41[17,93–77,74] vs 47,7[19,93–47,76], р=0,013) and higher value of bypass indicator (1,95[0,63–2,26] vs 1,31[1,13–1,31], р=0,0001) in patients with arterial hypertension and lower extremity arteries atherosclerosis compared to patients with isolated AH. Spastic (46% vs 14% р=0,0002) and spastic–atonic (30% vs 0%, р=0,0001) microcirculation types were reliably more often in main group compared to control group, whereas normal (0 vs 38%, p=0,0001) and stagnant (24% vs 48%, р=0,001) types were reliably rare. Concentric (62% vs 38%, р=0,004) and eccentric (8% vs 0%, р=0,0001) left ventricle hypertrophy (LVH) were found veraciously more frequently in patients with arterial hypertension and LEAA than in patient with AH and without LEAA. The binary logistic regression model was performed. It was determined that LVH risk was higher due to microcirculation index and capillary reserve decreasing in patients with arterial hypertension and lower extremity arteries atherosclerosis.Conclusion: spastic and spastic–atonic microcirculation types were reliably more often in main group compared to control group Endothelial disfunction, decreased tissue perfusion increased microcirculatory bypass and blood stagnation were detected in patients with AH and LEAA compared to patients with isolated AH. Concentric and eccentric left ventricle hypertrophy were found veraciously more frequently in patients with arterial hypertension and LEAA than in patient with AH and without LEAA and the risk of LVH was depended on microcirculation index and capillary reserve in patients of the main group.