НОВЫЕ МЕТОДЫ ОЦЕНКИ СУБКЛИНИЧЕСКИХ ИЗМЕНЕНИЙ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ ПРИ АРТЕРИАЛЬНОЙ ГИПЕРТОНИИ

Сердце анатомически и функционально связано с системой сосудов. Структурные и функциональные изменения в артериальном русле увеличивают постнагрузку на левый желудочек (ЛЖ) и могут изменять его функцию, приводя к адаптационной структурной перестройке ЛЖ. Систолическое артериальное давление (САД) в аорте, отражающее непосредственную нагрузку на ЛЖ, существенно отличается от САД в плечевой артерии за счет задержки появления отраженной волны в аорте. Левожелудочково-артериальное взаимодействие – концепция, которая помогает понять различные варианты «оптимального» функционирования сердечно-сосудистой системы, последствия изменений в артериальном русле для функции сердца. В обзоре приводятся методы анализа левожелудочково-артериального взаимодействия, клинические последствия его нарушения и эффекты антигипертензивной терапии, приводятся результаты собственных исследований. 

1. Kobalava ZD. Ventricular-arterial interaction: influence of age, hypertension, and a role in the pathogenesis of heart failure. In: Kobalava ZD, Kotovskaya YV, Akhmetov RE, Goncharov IS. Hypertension in the XXI century: achievements, problems, prospects. Moscow: Bionika Media; 2013: 193-208. In Russian (Кобалава Ж.Д. Желудочково-артериальное взаимодействие: влияние возраста, артериальной гипертонии и роль в патогенезе сердечной недостаточности. В: Кобалава Ж.Д., Котовская Ю.В., Ахметов Р.Е., Гончаров И.С. Артериальная гипертония в XXI веке: достижения, проблемы, перспективы. Москва: Бионика Медия; 2013: 193-208).

2. Mikhailov GV, Orlova YA, Ageev FT. Cardiovascular pairing: clinical significance, methods of assessment and the possibility of drug correction. Serdechnaya Nedostatochnost 2012; 13 (2): 111-7. In Russian (Михайлов Г.В., Орлова Я.А., Агеев Ф.Т. Сердечно-сосудистое сопряжение: клиническое значение, методы оценки и возможности медикаментозной коррекции. Сердечная Недостаточность 2012; 13(2):111-7).

3. Saba PS, Cameli M, Casalnuovo G, et al. Ventricular-vascular coupling in hypertension: methodological considerations and clinical implications. J Cardiovasc Med (Hagerstown) 2014;15(11):773-87.

4. Westerhof N, Sipkema P, van den Bos GC, Elzinga G. Forward and backward waves in the arterial system. Cardiovasc Res 1972; 6:648-56.

5. Burattini R, Knowlen GG, Campbell KB. Two arterial effective reflecting sites may appear as one to the heart. Circ Res 1991; 68:85-99.

6. Avolio AP, Chen SG, Wang RP, et al. Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation 1983; 68:50-8.

7. O’Rourke M. Arterial function in health and disease. Edinburgh: Churchill Livingstone; 1982.

8. McEniery CM, Yasmin. Hall IR, et al. Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity: the AngloCardiff Collaborative Trial (ACCT). J Am Coll Cardiol 2005; 46: 1753-60.

9. Baksi AJ, Treibel TA, Davies JE, et al. A meta-analysis of the mechanism of blood pressure change with aging. J Am Coll Cardiol 2009; 54:2087-92.

10. Nichols WW, O’Rourke MF. McDonald’s blood flow in arteries. London: Edward Arnold; 1990.

11. Kelly R, Karamanoglu M, Gibbs H, et al. Noninvasive carotid artery pressure wave registration as an indicator of ascending aortic pressure. J Vasc Med Biol 1989; 1:241-7.

12. Hamilton WF, Dow P. An experimental study of the standing waves in the pulse propagated through the aorta. Am J Physiol 1939; 125:48-59.

13. O’Rourke MF, Kelly RP, Avolio AP. The arterial pulse. Philadelphia: Lea & Febiger; 1992.

14. Nichols WW, O’Rourke MF, Avolio AP, et al. Effects of age on ventricular-vascular coupling. Am J Car-diol 1985; 55:1179-84.

15. Tyberg JV, Bouwmeester JC, Shrive NG, Wang JJ. Cross Talk opposing view: forward and backward pressure waves in the arterial system do not represent reality. J Physiol 2013; 591:1171-3.

16. Westerhof N, Westerhof BE. CrossTalk proposal: Forward and backward pressure waves in the arterial system do represent reality. J Physiol 2013; 591(5):1167-9.

17. Rogoza AN, Heymets GI, Pevzner A., et al. Key factors circulatory instability in the orthostatic test the possibility of objective analysis. Izvestiya YuFU. Tekhnicheskie nauki 2000; 4: 112-5. In Russian (Рогоза А. Н., Хеймец Г. И., Певзнер А. В., и др. Ключевые факторы неустойчивости системы кровообращения при ортостатических пробах возможности объективного анализа. Известия ЮФУ. Технические науки 2000;4:112-5).

18. Legkonogov AV, Kubyshkin VF, Heymets GI, et al. Echocardiographic evaluation of the pumping function of the heart by means of post-exercise performance. Kardiologiia 1992; 6: 68-70. In Russian (Легконогов А.В., Кубышкин В.Ф., Хеймец Г.И., и др. Эхокардиографическая оценка насосной функции сердца с помощью постнагрузочных характеристик. Кардиология 1992; 6: 68-70).

19. Rahimov SE, Sakharov MP, Trubetskoy AV, Ponomarev YA. Ways to assess the contractility of the heart and heart muscle. Vestnik AMN SSSR 1988; 5: 59-67. In Russian (Рагимов С.Э., Сахаров М.П., Трубецкой А.В., Пономарев Ю.А. Пути оценки сократительной способности сердца и сердечной мышцы. Вестник АМН СССР 1988; 5: 59-67).

20. Sunagawa K, Maughan WL, Burkhoff D, Sagawa K. Left ventricular interaction with arterial load studied in isolated canine ventricle. Am J Physiol 1983; 245:H773-80.

21. Suga H. Theoretical analysis of a left-ventricular pumping model based on the systolic time-varying pressure-volume ratio. IEEE Trans Biomed Eng 1971; 18:47-55.

22. Chantler PD, Lakatta EG, Najjar SS. Arterial-ventricular coupling: mechanistic insights into cardiovascular performance at rest and during exercise. J Appl Physiol 2008; 105:1342-51.

23. Sunagawa K, Maughan WL, Sagawa K. Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle. Circ Res 1985; 56:586-95.

24. Kelly RP, Ting CT, Yang TM, et al. Effective arterial elastance as index of arterial vascular load in humans. Circulation 1992; 86:513-21.

25. Saba PS, Ganau A, Devereux RB, et al. Impact of arterial elastance as a measure of vascular load on left ventricular geometry in hypertension. J Hypertens 1999; 17:1007-15.

26. Mitchell GF. Arterial stiffness and wave reflection in hypertension: pathophysiologic and therapeutic implications. Curr Hypertens Rep 2004; 6:436-41.

27. Saba PS, Roman MJ, Ganau A, et al. Relationship of effective arterial elastance to demographic and arterial characteristics in normotensive and hypertensive adults. J Hypertens 1995; 13:971-7.

28. Sasayama S, Asanoi H. Coupling between the heart and arterial system in heart failure. Am J Med 1991; 90:14S-18S.

29. Little WC, Pu M. Left ventricular-arterial coupling. J Am Soc Echocardiogr 2009; 22:1246-8.

30. Starling MR. Left ventricular-arterial coupling relations in the normal human heart. Am Heart J 1993; 125:1659-66.

31. Hayward CS, Kalnins WV, Kelly RP. Gender-related differences in left ventricular chamber function. Cardiovasc Res 2001; 49:340-50.

32. Nikolaeva OA, Zhirov IV, Uskach TM, Tereshchenko SN. Cardiovascular pairing: modern methods of assessment, predictive value and clinical applications in acute decompensation of chronic heart failure. Meditsinskiy Vestnik Severnogo Kavkaza 2015; 10 (4): 12-8. In Russian (Николаева О.А., Жиров И.В., Ускач Т.М., Терещенко С.Н. Сердечно-сосудистое сопряжение: современные методы оценки, прогностическая значимость и возможности клинического применения при острой декомпенсации хронической сердечной недостаточности. Медицинский вестник северного Кавказа 2015; 10(4):12-8).

33. Devlin WH, Petrusha J, Briesmiester K, Montgomery D, Starling MR. Impact of vascular adaptation to chronic aortic regurgitation on left ventricular performance. Circulation 1999; 99:1027-33.

34. Dikur ON, Poltavskaya MG, Giverts IJ, et al. Ventricular-arterial pairing with chronic heart failure with preserved and reduced left ventricular ejection fraction. Kardiologiya i Serdechno-sosudistaya Khirurgiya 2014; 4 (7): 59-68. In Russian (Дикур О.Н., Полтавская М.Г., Гиверц И.Ю., и др. Желудочково-артериальное сопряжение при хронической сердечной недостаточности с сохранённой и сниженной фракцией выброса левого желудочка. Кардиология и Сердечно-сосудистая Хирургия 2014; 4(7):59-68).

35. Rinder MR, Miller TR, Ehsani AA. Effects of endurance exercise training on left ventricular systolic performance and ventriculoarterial coupling in patients with coronary artery disease. Am Heart J 1999; 138:169-74.

36. Nitenberg A, Antony I, Loiseau A. Left ventricular contractile performance, ventriculoarterial coupling, and left ventricular efficiency in hypertensive patients with left ventricular hypertrophy. Am J Hyper-tens 1998; 11:1188-98.

37. Nichols WW, O’Rourke MF. Wave reflection and myocardial oxygen supply and demand. In: Nichols W, O'Rourke M, Vlachopoulos C. Mc Donald’s blood flow in the arteries. theoretical, experimental and clinical principles. London: Edward Arnold; 1998: 218-9.

38. Pedrinelli R, Ballo P, Fiorentini C, et al. Hypertension and stable coronary artery disease. J Cardiovasc Med 2013; 14:545-52.

39. Avolio AP, Van Bortel LM, Boutouyrie P, et al. Role of pulse pressure amplification in arterial hypertension: experts’ opinion and review of the data. Hypertension 2009; 54:375-83.

40. Hashimoto J, Imai Y, O’Rourke MF. Indices of pulse wave analysis are better predictors of left ventricular mass reduction than cuff pressure. Am J Hypertens 2007; 20:378-84.

41. Iketani T, Iketani Y, Takazawa K, Yamashina A. The influence of the peripheral reflection wave on left ventricular hypertrophy in patients with essential hypertension. Hypertens Res 2000; 23:451-8.

42. Kobayashi S, Yano M, Kohno M, et al. Influence of aortic impedance on the development of pressure-overload left ventricular hypertrophy in rats. Circulation 1996; 94:3362-8.

43. Hashimoto J, Westerhof BE, Westerhof N, et al. Different role of wave reflection magnitude and timing on left ventricular mass reduction during antihypertensive treatment. J Hypertens 2008; 26:1017-24.

44. Chung CS, Strunc A, Oliver R, Kova´cs SJ. Diastolic ventricular-vascular stiffness and relaxation relation: elucidation of coupling via pressure phase plane-derived indexes. Am J Physiol Heart Circ Physiol 2006; 291:H2415-H2423.

45. Borlaug BA, Melenovsky V, Redfield MM, et al. Impact of arterial load and loading sequence on left ventricular tissue velocities in humans. J Am Coll Cardiol 2007; 50:1570-7.

46. Canepa M, Alghatrif M, Strait JB, et al. Early contribution of arterial wave reflection to left ventricular relaxation abnormalities in a communitydwelling population of normotensive and untreated hypertensive men and women. J Hum Hypertens 2014; 28:85-91.

47. Zannoli R, Schiereck P, Celletti F, et al. Effects of wave reflection timing on left ventricular mechanics. J Biomech 1999; 32:249-54.

48. Borlaug BA, Lam CSP, Roger VL, et al. Contractility and ventricular systolic stiffening in hypertensive heart disease insights into the pathogenesis of heart failure with preserved ejection fraction. J Am Coll Cardiol 2009; 54:410-8.

49. Fox JM, Maurer MS. Ventriculovascular coupling in systolic and diastolic heart failure. Curr Heart Fail Rep 2005; 2:204-11.

50. Chen CH, Nakayama M, Nevo E, et al. Coupled systolic-ventricular and vascular stiffening with age: implications for pressure regulation and cardiac reserve in the elderly. J Am Coll Cardiol 1998; 32: 1221-7.

51. Lam CSP, Shah AM, Borlaug BA, et al. Effect of antihypertensive therapy on ventricular-arterial mechanics, coupling, and efficiency. Eur Heart J 2013; 34:676-83.

52. Osranek M, Eisenach JH, Khandheria BK, et al. Arterioventricular coupling and ventricular efficiency after antihypertensive therapy: a noninvasive prospective study. Hypertension 2008; 51:275-81.

53. Williams B, Lacy PS, Thom SM, et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113:1213-25.

54. de Luca N, Asmar RG, London GM, et al., REASON Project Investigators. Selective reduction of cardiac mass and central blood pressure on low-dose combination perindopril/indapamide in hypertensive subjects. J Hypertens 2004; 22:1623-30.

55. Dahlo¨f B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359:995-1003.

56. Mitchell GF, Izzo JL Jr, Lacourcie`re Y, et al. Omapatrilat reduces pulse pressure and proximal aortic stiffness in patients with systolic hypertension: results of the conduit hemodynamics of omapatrilat international research study. Circulation 2002; 105:2955-61.

57. Kass DA, Shapiro EP, Kawaguchi M, et al. Improved arterial compliance by a novel advanced glycation end-product crosslink breaker. Circulation 2001; 104:1464-70.