Linkage of Left Ventricle Hypertrophic Geometric Models With Clinical, Metabolic-Hormonal Parameters and Mineral Metabolism in Hypertensive Patients

Abstract

Objective: To analyze the association of hypertrophic geometric models of the left ventricle (LV) with changes in clinical, anthropometric and metabolic-hormonal parameters and of mineral metabolism data in patients with essential arterial hypertension (EAH). Design and method: The case-control study involved 100 patients with EAH stage II, 1-3 degrees of blood pressure value (BP), high and very high cardiovascular risk. Among the patients there were 21% (21) men, 79% (79) women, the mean age 59.86±6.22y.o. The control group consisted of 60 practically healthy individuals, relevant in age (49.13±6.28y.o.) and gender distribution (63% - women, 37% - men). The lipid panel parameters, such as: TC (Total cholesterol), TG (Triglycerides), LDL-C (Low-density lipoprotein cholesterol), HDL-C (High-density lipoprotein cholesterol) were investigated in blood plasma. All recruited subjects were tested for serum levels of fasting glucose, ionized calcium, parathyroid hormone (PTH), 25-hydroxyvitamin D (Vit D). LV hypertrophy (LVH) and LVH models were assessed by echocardiography. Results: Eccentric LVH (ELVH) in EAH patients is associated with higher blood pressure than Concentric LVH (CLVH): Systolic blood pressure and Diastolic blood pressure are higher by 3.29% and 3.95%(p<0,05-0,04). ELHV associates with higher body mass index and waist circumference in women - by 7.80% and 7.40% (p<0.05-0.048), respectively. In addition, the ELVH was characterized by a lower ionized Ca2+ level in the blood than CLVH by 2.54% (p = 0.021) with a compensatory higher concentration of PTH by 23.86% (p = 0.047), which indicates the calcium homeostasis intensity in EAH patients. The lipids and glucose serum concentration as well as Vit D level do not associate with any of hypertrophic models of myocardium. Conclusions: Lipid profile, blood glucose and Vit D concentration do not determine the development of any type of the LVH. ELVH is associated with lower Ca2+ level of and consequently with elevated PTH value.