[Left ventricular myocardial geometry in arterial hypertension in patients with stenosing cerebral atherosclerosis]

Area of Science:

• Cardiology
• Neurology
• Vascular Medicine

Background:

• Arterial hypertension (AH) and cerebral atherosclerosis are significant cardiovascular risk factors.
• Circulatory and hemodynamic disturbances are common in patients with AH and cerebral atherosclerosis.
• Myocardial remodeling is a known consequence of sustained hemodynamic stress.

Purpose of the Study:

• To clarify the relationship between common carotid artery (CCA) circulatory issues and hemodynamic/myocardial remodeling in AH patients with cerebral atherosclerosis.
• To investigate how the degree of CCA stenosis influences hemodynamic patterns and left ventricular (LV) structure.
• To understand the progression of atherosclerotic lesions and their impact on cardiovascular remodeling.

Main Methods:

• Carotid arterial Doppler ultrasonography was used to assess CCA hemodynamics.
• Echocardiography (echoCG) evaluated structural myocardial remodeling.
• Central hemodynamic variables were measured in 83 patients with AH and cerebral atherosclerosis.

Main Results:

• Patients with moderate CCA stenosis and AH more frequently exhibited a hyperkinetic hemodynamic type.
• Patients with severe CCA stenosis and AH were more commonly associated with a hypodynamic hemodynamic type.
• Left ventricular myocardial remodeling, particularly asymmetric hypertrophy, was more prevalent in patients with severe CCA stenosis.

Conclusions:

• The severity of CCA stenosis correlates with specific hemodynamic patterns (hyperkinetic vs. hypodynamic) in patients with AH and cerebral atherosclerosis.
• Severe CCA stenosis is linked to a higher incidence of LV myocardial remodeling.
• Dissociation between central and regional hemodynamics, driven by atherosclerotic progression, contributes to myocardial remodeling.