RESUMO
The purpose of this study was to define a correlation between N-terminal proBNP level and extent of cardiac abnormalities. A total of 40 patients with hypertension were included in the study (60.5+/-7.6 years of age; 18 men, 22 women). It was found that patients with hypertension had increased plasma N-terminal proBNP level, that it increased with age and tended to be higher in patients with concentric hypertrophy compared with those with normal geometry and eccentric hypertrophy; however, the differences were not significant. N-terminal proBNP concentration depended on ventricular septal thickness and left ventricular wall thickness. Analysis of association between N-proBNP level and parameters of myocardial diastolic function showed that increased plasma peptide levels correlated with degree of diastolic dysfunction in patients with altered left ventricular relaxation.
Assuntos
Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Idoso , Feminino , Coração/anatomia & histologia , Coração/fisiologia , Coração/fisiopatologia , Testes de Função Cardíaca , Ventrículos do Coração/fisiopatologia , Humanos , Hipertensão/sangue , Hipertensão/patologia , Hipertrofia Ventricular Esquerda , Masculino , Pessoa de Meia-Idade , Remodelação VentricularRESUMO
Aim of the study--investigation of dynamics of levels of serum markers of myocardial fibrosis matrix metalloproteinase-1 (MMP-1), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1)--at the background of 3 months hypotensive therapy in 39 patients with arterial hypertension and paroxysmal form of atrial fibrillation. Twenty patients received sotalol, 19--retard form of verapamil. After 3 months of hypotensive therapy in all patients and separately in groups of patients receiving sotalol and verapamil no significant changes of MMP-1 and TIMP-1 occurred. However in patients with most pronounced hypotensive effect according to 24-hour blood pressure monitoring significant elevation of MMP-1 and lowering of TIMP-1 levels took place. This was associated with improvement of ventricular diastolic function. In most patients longer period of therapy (more than 3 months) is required for achievement of regression of damage to the heart.
Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Hipertensão/enzimologia , Metaloproteinase 1 da Matriz/sangue , Inibidor Tecidual de Metaloproteinase-1/sangue , Vasodilatadores/uso terapêutico , Verapamil/uso terapêutico , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Ensaio de Imunoadsorção Enzimática , Feminino , Fibrose/enzimologia , Fibrose/etiologia , Fibrose/patologia , Seguimentos , Cardiopatias/enzimologia , Cardiopatias/etiologia , Cardiopatias/patologia , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Masculino , Metaloproteinase 1 da Matriz/efeitos dos fármacos , Pessoa de Meia-Idade , Miocárdio/patologia , Sotalol/uso terapêutico , Inibidor Tecidual de Metaloproteinase-1/efeitos dos fármacos , Resultado do TratamentoRESUMO
Aim of the study was to investigate interrelationship between serum markers of myocardial fibrosis: matrix metalloproteinase -1 (MMP-1), tissue inhibitor of metalloproteinase-1 (TIMP-1) and parameters of echocardiography in patients with arterial hypertension (AH) and paroxysmal form of atrial fibrillation (n=39). We revealed positive correlation of levels of TIMP-1 with thickness of interventricular septum in diastole (r=0,47, p=0,02), peak velocity of late filling of the right ventricle (r=0,46, p=0,01), and negative relation between MMP-1 levels and degree of mitral and tricuspid regurgitation (r=0,43, p=0,005 and r=0,38, p=0,04, respectively). In the group of patients with increased left ventricular myocardial mass index (LVMMI) TIMP-1 level was significantly higher than in patients with normal LVMMI (p < 0,05). In the group combining patients with concentric and eccentric LV hypertrophy TIMP-1 level was significantly higher than in the group combining patients with LV concentric remodeling and normal geometry (p < 0,05). No correlations were revealed between MMP-1 and TIMP-1 levels and parameters of diastolic dysfunction. In patients with AH increase of serum concentrations of TIMP-1 was associated with increased thickness of interventricular septum, increase of LVMMI, and with prognostically unfavorable types of LV remodeling.