Smoking as the main regulative cardiovascular risk factor in complex pathologic remodeling and heart rate variability changes in hypertensive patients

Abstract

Objective. To assess the value of smoking in early left ventricular (LV) remodeling in hypertensive patients. Design and methods. Two groups of patients with arterial hypertension (AH) (95 non-smoking subjects and 39 smoking patients) and a group of healthy individuals were analyzed. All of them underwent echocardiography (Echo-CG). Results. No significant distinction in cardiac structural and functional characteristics in smokers and non-smoking hypertensive patients were found at routine echo-CG. However, we found the increase of myocardial diastolic stress (MSd, p = 0,05) and LV end diastolic strain (EDS, p = 0,05), as well as the prevalence eccentric LV hypertrophy in smoking hypertensive patients (р < 0,05). Compared to healthy patients, hypertensive smoking and non-smoking subjects had higher LV mass index and RWT (р < 0,05), as well as the increased MSs and MSd (р < 0,05), higher values of LV end diastolic pressure (EDP) and EDS and altered structural and functional interrelation in LV (ejection fraction to myocardial stress (EF/MS), myocardial stress-volume (MSs/ESVI, р < 0,05). Conclusions. In spite of the absence of any significant influence of smoking on LV function in current time, smoking promotes the increase of burden on myocardium and strain of LV, impaired interrelationship between structure and function, followed by more frequent development of eccentric LV hypertrophy.