The use of different threshold values can significantly influence the assessment of prevalence of LVH in hypertension. The "mild" criteria, to our opinion, can overestimate the prevalence of structural LV remodelling, while implementation of sex-specific criteria for the definition of LVH increases the sensitivity of the method. In any way, eccentric LVH is as common for hypertension as a concentric LVH, the proportion of the latter increasing with age and more frequently observed in males. Concomitant obesity, in particular abdominal, significantly increases LVH prevalence.

Patients with thyreotoxicosis have variable clinical manifestations and various degree of cardiomyopathy which severity depends on many factors. Last years the genetic factors predicting development and clinical features of thyrotoxic symptoms and thyreotoxic cardiomyopathy became more evident. It is known, that production of T3 in various tissues including cardiac muscle is limited by deiodinase 2 (D2). Resent studies showed that certain polymorphisms, including Thr92Ala of D2 gene, are implicated in the development of thyrotoxic symptoms and thyreotoxic cardiomyopathy. Individuals with Ala92Ala genotype have lower D2 activity in tissues compared to other genotypes. In our study we focused on codon 92 polymorphism of D2 gene in relation to clinical manifestations of thyreotoxic cardiomyopathy and Echo-cardiography parameters in patients with Graves' disease.

eft ventricular hypertrophy (LVH) is generally believed to be an independent risk factor in hypertension, 1-5 and the possibility and beneficial effect of reversing LVH during antihypertensive treatment have been well documented in clinical studies. [6][7][8][9][10] However, little is known about the evolution of left ventricular (LV) geometry in untreated subjects, because of the difficulties of long-term follow-up for humans and the ethical problems of organising a prospective study of untreated patients.There are 4 patterns of LV geometry in hypertension, classified according to the LV mass (LVM) index and relative wall thickness (RWT), 11 and it is now well established that the LV geometry pattern is closely related to LV function and the patient's prognosis. 12,13 Thus, concentric LVH is associated with a higher risk of cardiac arrhythmias, and even sudden death, 12 and the literature is replete with evidence that concentric LVH strongly predicts the development of heart failure. 13,14 In addition, the evidence is accumulating that eccentric LVH is frequently observed in the early stages of hypertension, 15-17 but little is known whether the geometry patterns are necessary consequent stages in the development of the hypertensive heart from normal geometry through LVH to LV dilatation and heart failure, or if every pattern is genetically and/or hemodynamically predisposed. Finally, the natural history of the transition from 1 pattern to another is still unknown, as are the changes in the geometry patterns during antihypertensive therapy.The present study investigated the changes in LVM, diastolic function, and geometry in hypertensive patients in a prospective 5-year follow-up in concordance with an evaluation of the regularity and effectiveness of treatment. Methods PatientsHypertensive patients older than 18 years from one of the city districts of St Petersburg who were in the patient database of the outpatient clinic, were screened for the study. Because no other option for outpatient care is available in this area, the vast majority of patients with essential hypertension are seen in the selected healthcare center. Patients were recruited for the study during their annual check-up from 1995 to 1998. The selection criteria were: (1) previously established diagnosis of essential hypertension (=1 year) based on the standard criteria (3 consecutive measurements of blood pressure (BP) in the right brachial artery while seated: >140 mmHg for systolic BP and/or >90 mmHg for diastolic BP); (2) Background Left ventricular hypertrophy (LVH), as well as the geometry pattern of the left ventricle, is believed to be an independent risk factor for hypertension. The present study investigated the changes in left ventricular mass, diastolic function and geometry in hypertensive patients in a prospective 5-year follow-up in conjunction with an evaluation of the regularity and effectiveness of treatment. Methods and ResultsOne hundred hypertensive patients older than 18 years were examined according to the study protocol...

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