STRUCTURAL AND FUNCTIONAL STATE OF MIOCARDIUM IN PATIENTS WITH UNCOMPLICATED ANEURYSM OF ASCENDING AORTA

Aim. To search for additional risk stratification criteria, progression and complications of aortic aneurysm, and to optimize the tactical approach to monitoring and treatment. Causes and methods of diagnosis and treatment of aortic aneurysm, including its thoracic part, are currently explored in some detail. But questions of treatment procedure in these patients, division into groups for conservative and surgical treatment are discussed, as often the risk of complications may be different in patients with with aneurysms of the same size but different etiology, comorbidity factors, and age. Material and Methods. The study involved 154 patients with enlargement of the root and/or ascending aorta over 40 mm according to the echocardiographic study. Patients were divided into 4 categories by age: 18-29 years; 30-44 years; 45-59 years; and 60-74 years. Instrumental examination methods included: echocardiography, ECG monitoring and blood pressure, determination of heart rate variability. Statistical analysis was carried out by methods of variation statistics program StatSoft "Statistica" v.10.0 Results and Discussion. In the process of observation at 12 and 24 months fixed progression of changes in the state of the heart and aorta was observed. The size of the left ventricle and left atrium were significantly increased; left ventricle hypertrophy progressed; root and ascending aorta were expanded. For quantitative echocardiographic assessment of the nature-change in patients with aortic aneurysm a total figure was applied that included changing the 4 echocardiographic parameters and calculated as the sum of points. Based on mathematical analysis, the total score and echocardiogram parameters of heart rate variability was determined and the potency of individual independent predictors for dynamic echocardiography-indicators was evaluated. With the use of Spearman rank correlation analysis, a direct correlation between the total index echocardiography and theage of patient, body weight and total score of heart rate variability was found. Conclusions. It was found that in patients with aneurysm of the ascending aorta the character of echocardiography dynamics was most significantly influenced by body weight over 82 kg, age over 58 years and hypersympathicotonia (heart rate variability score over 1.0). Key words: aneurysm of the ascending aorta, causal factors, connective tissue disorder, coronary heart disease, hypertension