[Features of fibrosis and disorders of the collagen metabolism of the interstitial matrix of the myocardium in patients with arterial hypertension and possibilities of their correction with sartname.]

Metabolic disorders of the interstitial heart and vessels matrix in hypertension develop due to chronic stretching of their walls. For estimation the involutive and hypertensive changes in interstitial matrix of the heart and vessels we have been examined 30 normotensive elderly women and 30 patients of same age with arterial hypertension (AH) II stage, as well as the possibility of their correction by valsartan and veroshpiron. The next parameters of investigation used: the volume fraction of interstitial collagen (VFIC) in myocardium, cardiovascular conjugation (CVC), serum concentrations of markers of systemic collagenogenesis - COL-1, TGF-ß1, MMP-1, TIMP-1, Gal-3. CVC reflected the hard-elastic properties of the myocardium and arterial vessels, which was elevated in women with AH. A high intensity of LV myocardial fibrosis was revealed with a significant increase in the VFIC content in elderly patients with AH compared with normotensive patients. This is due to the increased activity of fibrosis markers. There was a decrease in their level after antihypertensive therapy, which proved its antifibrotic effect.

[Involutive and hypertensive fibrosive transformation of the heart in formation of myocardial dysfunction and chronic heart failure.]

To assess the conjugation of involutive and hypertensive fibrotic transformation of the heart formation with myocardial dysfunction and chronic heart failure (CHF), 30 normotensive individuals and 60 elderly patients with arterial hypertension (AH) (mean age - 66±0,7 years) were examined by echo and dopplercardiography, estimation of the volume fraction of interstitial collagen (VFIC) in the myocardium, serum concentrations of markers of systemic collagenogenesis, using a six-minute walk test. A higher intensity of LV myocardial fibrosis was revealed with a significant increase in the VFIC content in elderly patients with AH compared with normotensive patients, which indicates the predominance of interstitial collagenogenesis over collagenolysis. The increased content of fibrous tissue in myocardial interstitium caused the development of unfavorable types of cardiac remodeling and the progression of diastolic dysfunction, negatively affecting the functional reserve of the circulatory system, as evidenced by negative correlations between the level of the VFIC and the results of a 6-minute walk test: weak in patients with I FC CHF, moderate strength in patients with AH with II FC CHF.