Abstract:
To conduct a comprehensive study of patients with ischemic heart disease (IHD) in combination with arterial hypertension (AH) complicated by chronic heart failure (HF) 2A and 2B, by studying parameters of intracardiac hemodynamics considering the pressure in the pulmonary artery. We examined 120 patients with coronary heart disease in combination with hypertension aged 44 to 90 years old (mean age 72.29 ± 1.66), the majority were men (86.7%). All patients were divided into two groups according to the degree of heart failure: HF 2A – 54 persons, with HF 2B – 66 people. The groups were compared in age, gender, functional class of IHD, severity of AH and HF. Analysis of heart ultrasound showed the following. In IHD in combination with hypertension, complicated by HF 2A, the pressure in the pulmonary artery rises in an average to 46.46 ± 3.64 mm Hg and it increases in HF 2B to 57.00 ± 5.19 mm Hg, that corresponding to the average level of pulmonary hypertension (p <0.01); at the same time, the fraction of ejection of left ventricle in the first patients decreases moderately up to 45.96 ± 2.01%, in others – to 39.93 ± 1.99% (p <0.01). In patients with IHD in combination with hypertension complicated by chronic heart failure the structural and functional changes are formed on the side of the left heart, accompanied by an increase in their size due to hypertrophy, formation of stagnant phenomena, regurgitation, functional state disorders by the restrictive type, progressive systolic and diastolic dysfunction, increased pressure in the pulmonary artery. Consideration of pulmonary hypertension, along with other parameters of intracardiac hemodynamics, is an important component in determining the degree and nature of heart failure, which requires the selection of adequate and timely therapeutic tactics.
