RESUMEN
The paper contains data on specific features of cardiac involvement in primary and secondary hemochromatosis (symptomatology, echocardiographic signs, etc.) as well as on pathogenesis of hereditary hemochromatosis. Algorithm of diagnosis of hereditary hemochromatosis is also presented.
Asunto(s)
Cardiomiopatías/etiología , Hemocromatosis/complicaciones , Diagnóstico Diferencial , Hemocromatosis/diagnóstico , Hemocromatosis/genética , HumanosAsunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Antihipertensivos/farmacología , Arteria Braquial/efectos de los fármacos , Endotelio Vascular/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Isquemia Miocárdica/tratamiento farmacológico , Perindopril/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antihipertensivos/administración & dosificación , Antihipertensivos/uso terapéutico , Velocidad del Flujo Sanguíneo , Arteria Braquial/fisiología , Cromatografía Líquida de Alta Presión , Interpretación Estadística de Datos , Endotelinas/sangre , Endotelio Vascular/fisiología , Epoprostenol/sangre , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Isquemia Miocárdica/fisiopatología , Óxido Nítrico/sangre , Perindopril/administración & dosificación , Perindopril/uso terapéutico , Tromboxanos/sangre , Factores de Tiempo , VasodilataciónRESUMEN
AIM: To elucidate relationship between hereditary and environmental factors in development of target organ damage in hypertension. MATERIAL AND METHODS: The state of myocardium, central nervous system, blood vessels (including funduscopic examination) was assessed in 64 pairs of mono- and dizygous hypertensive twins (mean age 57.2+/-3.2 years) and clinical and genetic analysis of qualitative and quantitative signs was carried out. RESULTS: Hypertensive twins had similar qualitative features of target organs involvement irrespective of duration of hypertension. Concordance of signs of target organ damage in homozygous twins was more than twice higher than that of same signs in dizygous twin pairs. Left ventricular myocardial mass and intima-media thickness were mainly determined by hereditary factors. Their contribution into overall phenotypic variability of a sign exceeded 70%.
Asunto(s)
Enfermedades en Gemelos , Hipertensión/genética , Monitoreo Ambulatorio de la Presión Arterial , Vasos Sanguíneos/diagnóstico por imagen , Vasos Sanguíneos/patología , Arteria Carótida Común/diagnóstico por imagen , Arteria Carótida Común/patología , Enfermedades del Sistema Nervioso Central/complicaciones , Enfermedades en Gemelos/diagnóstico , Ecocardiografía , Ambiente , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/etiología , Hipertensión/patología , Hipertrofia Ventricular Izquierda/diagnóstico , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Hipertrofia Ventricular Izquierda/genética , Masculino , Persona de Mediana Edad , Fenotipo , Factores de Tiempo , Gemelos Dicigóticos , Gemelos MonocigóticosRESUMEN
Twenty four hour blood pressure monitoring was carried out in 64 sex concordant pairs of monozygotic and dizygotic hypertensive twins (mean age 52.7-/+3.2 years). Clinico-genetic analysis of quantitative parameters showed that during day awake time systolic, diastolic, and mean blood pressures were mainly determined by environmental factors while pulse pressure and heart rate were predominantly affected by genetic factors. Formation of parameters of variability of blood pressure and its biphasic rhythm were under the influence of random (intrafamily) environmental factors.