P212The use of erythrocyte indices for diagnosis of left ventricular hypertrophy in hypertensive women

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Abstract

The most available methods are ECG criteria for LVH: Sokolov-Lyon index (sensitivity 22%) and Cornell index (sensitivity 42%). More sensitive and specific in determining LVH is an echocardiogram. However, this method is relatively expensive and require high-tech equipment and trained professionals. The development of left ventricular hypertrophy in hypertensive patients is often compounded by impaired erythrocyte homeostasis (the most commonly anemia). Women often suffer from anemia, in addition, the indicators are susceptible to erythrocytic homeostasis physiological level fluctuations. Studies in animals and humans have shown that ischemic or hypertrophied myocardium is more sensitive for a slight decrease in hemoglobin than the unmodified myocardium.

The aim is to estimate the state of erythrocyte homeostasis in women with hypertension.

Were examined 58 women with essential hypertension (EH) stage 2, 2nd degrees. The age of women - 57 (11) years. Patients with symptomatic hypertension, arrhythmias, diabetes mellitus, hematological disorders were excluded from the study.

In all patients were carried determination of total hemoglobin (Hb), erythrocytes in 1 liter (Er), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV). Echocardiography was performed by standard ASE methods.

Statistical significance was defined at the level of methods for p < 0,05.

In assessing the relationship with indicators of erythrocyte homeostasis parameters, reflecting the structural state of the left ventricle of the heart in women with hypertension, we identified correlations between MCV and MCH with a wall thickness and index of left ventricular mass (R=0,38, p=0,003).

The most pronounced relationship was between the thickness of the posterior wall of the LV (LVPWd) and MCH. Construction of equations of the linear approximation possible to determine the thickness of diastlic LVPW by the formula

LVPWd = Kd + Kp * MCH,

where Kd - correlation correction of MCH, Kp - correction factor of MCH.

The described method of identifying LVH was applied in 58 women with EH. Based on research by constructing the correlation curve approximation method it was determined the value of Kd equal to 3.131 and the value of Kp equal to 0.2548.

When the values of the thickness of more than 11.9 LVPWd diagnosed left ventricular hypertrophy.

Thus, the results of the study indicate:

1. an association of erythrocyte indices with a wall thickness of the left ventricle in patients with EH;

2. the possibility to determine LVH in women with hypertensive patients using the value of MCH.

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