Finding Early Predictors of Myocardial Dysfunction in Patients With Hypertension
The concept and plan of study
1. The attempt to clarify the grounds of heart exertional dyspnoea stenocardial pain in
patients with well-controlled stage I or II hypertension according to ESH (European
Society of Hypertension), without changes in epicardial coronary arteries in coronary
angiography and normal resting echocardiography.
2. MRI evaluation of coronary microcirculation and endothelial function assessed by
flow-dependent vasodilation in hypertensive patients with and without heart failure
3. Comparison of modern echocardiographic methods and magnetic resonance imaging in the
diagnosis of hypertensive patients with and without overt heart failure.
4. Cystatin C as a new marker of organ damage in patients with hypertension and comparison
of cystatin C with GFR assessed by MDRD and Cockcroft-Gault creatinine clearance on as
renal function assessment indicators in patients with hypertension.
5. Evaluation of new markers - cardiotrophin 1 and cystatin C, serum syndecan-4, collagen
III N-terminal propetide [PIIINP], MMP-2, MMP-7,MMP-8, MMP-9 and NT-proBNP in the early
diagnosis of heart failure.
6. Potential markers of heart failure, modern echocardiography methods and magnetic
resonance imaging in the detection of asymptomatic myocardial dysfunction in order to
increase the effectiveness of prevention and treatment.
7. Searching for the relationship between the type of hypertension (dipper or non-dipper)
and the development of heart failure symptoms, and whether there are differences
between the echocardiographic images of these patients?
8. Selection of patients with hypertension, in whom an early introduction of
pharmacological treatment of heart failure should be considered.
9. The study will also help answer the following questions: (a) Which parameters best
assess the overall cardiovascular risk? and (b) When the treatment of heart failure in
patients with hypertension should start.
The measurable effect of this research besides cognitive is to the possibility of reducing
the proportion of patients who come to overt heart failure connected with hypertension
through the optimization of preventive, diagnostic methods and to determine the optimum
treatment in these patients.
Observational Model: Case Control, Time Perspective: Prospective
Changes in levels of biomarkers
Levels of markers: cystatin C, cardiotrophin-1, metaloproteinases: MMP-2, MMP-7, MMP-8, MMP-9, Procollagen III N-Terminal Propeptide (PIIINP), Syndecan 4 (SDC4) and NT-proBNP
Agata Bielecka-Dabrowa, MD, PhD
Medical University of Lodz
United States: Institutional Review Board