Influence of basic complex two-year therapy on indicators of late remodeling of the left ventricle and prophylaxis of the occurrence of cardiovascular events in patients after unstable angina combined with arterial hypertension
DOI:
https://doi.org/10.14739/2310-1237.2019.2.177198Keywords:
unstable angina pectoris, cardiac remodeling, treatmentAbstract
The purpose of the study was to determine the effect of basic complex biennial treatment on the parameters of late remodeling of the left ventricle (LV) and cardiovascular events in patients after unstable angina (UA) in combination with arterial hypertension (AH).
Materials and methods. A total of 144 patients with unstable angina in combination with arterial hypertension, at the age of 41–67 years, who were treated in the infarct department of City Clinical Hospital № 1 in Vinnytsya, who had a history of myocardial infarction in 59.7 % of cases, were examined. The duration of hypertension was 9.3 years on average, chronic CHD – 6.4 years; systolic blood pressure – 163.2 ± 1.50 mm Hg, diastolic blood pressure – 101.1 ± 0.67 mm Hg. The patients underwent general clinical examination, ECG, echocardiography in M- and B-regimens, lipid blood spectrum and troponin I. The examinations were carried out before treatment, after 6, 12 and 24 months. Basic complex treatment was carried out for two years with perindopril 5–10 mg/day, bisoprolol 5–10 mg/day, atorvastatin 20 mg/day and acetylsalicylic acid 75 mg/day.
Results. In the examined patients after thе UA in combination with hypertension before the treatment concentric left ventricular hypertrophy (LVH) according to A. Genau was determined in 40.3 %, eccentric – in 58.3 %, concentric remodeling – in 1.4 %. After conducting the basic comprehensive treatment, the concentric LVH decreased and the eccentric increased.
In patients after UA in combination with hypertension before treatment I (initial) degree of LVH was determined in 6.3 %, II (moderate) – 26.4 %, III (significant) –in 66.7 %. After the basic comprehensive treatment, the third (significant) level of LVH significantly decreased due to the gradual transition to the second and the first stage of late remodeling of the LV. While studying the development of cardiovascular events it was found, that two years mortality was 2.1 %, recurrent not fatal myocardial infarction was registered in 10.4 % of cases.
Conclusions. In patients after the UA in combination with hypertension conducted two-year basic complex antiremodeling treatment was accompanied in a number of cases by the transition of concentric remodeling of LV to the eccentric one and a reducеion in risk of cardiovascular events development.
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