Alteraciones ecocardiográficas en pacientes con hipertensión arterial

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Abstract

Se realizó un estudio descriptivo transversal de 120 pacientes hipertensos con 5 o más años de evolución, quienes acudieron al cuerpo de guardia del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba, desde noviembre de 2010 hasta igual mes de 2011, con vistas a determinar la presencia o ausencia de alteraciones ecocardiográficas típicas de hipertensión arterial. De ese total, 78,3 % resultaron afectados, la mayoría de los cuales refirieron no seguir tratamiento médico previo regular y 21,7 % no presentaron estas modificaciones. En la casuística predominaron el grupo etario de 50-60 años, el sexo masculino y el color negro de la piel. Los hallazgos ecocardiográficos más llamativos fueron: la hipertrofia ventricular izquierda y la insuficiencia cardíaca con fracción de eyección del ventrículo izquierdo conservada.

Translated abstract

A descriptive cross-sectional study was carried out in 120 hipertensive patients with a course of 5 or more years, who went to the emergency room of "Saturnino Lora" Provincial Teaching Hospital from November 2010 to November 2011 in order to determine the presence or absence of echocardiographic abnormalities typical of hypertension. Of these, 78,3 % was affected, most of whom reported not to continue with regular previous medical treatment, and 21,7 % had not these abnormalities. Age group of 50-60 years, males and blacks prevailed in the case material. The most significant echocardiographic findings were left ventricular hypertrophy and heart failure with ejection fraction of left ventricle preserved.

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Javier Diez, Arantxa González, Begoña López … (2005)

Changes in the composition of cardiac tissue develop in arterial hypertension and lead to structural remodeling of the myocardium. Structural remodeling is the consequence of a number of pathologic processes, mediated by mechanical, neurohormonal and cytokine routes, occurring in the cardiomyocyte and the noncardiomyocyte compartments of the heart. One of these processes is related to the disruption of the equilibrium between the synthesis and degradation of collagen type I and III molecules, which results in an excessive accumulation of collagen type I and III fibers in the interstitium and the perivascular regions of the myocardium. The clinical relevance of ventricular fibrosis is that it might contribute to the increased cardiac risk of patients with hypertensive heart disease. This review focuses on the mechanisms of hypertensive ventricular fibrosis and its clinical consequences. In addition, we discuss the noninvasive methods for the diagnosis of cardiac fibrosis and the therapeutic strategies aimed to promote its reduction.