Special features of endocardial hemodynamics and autonomic regulation in young healthy individuals with normal cardiac geometry and concentric left ventricular remodeling
Cardiac remodeling is a complex multifactorial process that is crucially significant for prognosis in patients with any cardiovascular disease. The objective of this work is the comparative study of special features of endocardial hemodynamics, daily blood pressure and ECG monitoring profile, and autonomic regulation in young (18-44 years) healthy individuals with normal heart geometry and concentric remodeling of the left ventricle. The study involved healthy volunteers aged 18 to 42, whose average age was 25.3±0.6 years, including 56 (73.7%) men and 20 (26.36%) women. Depending on the relative wall thickness of the left ventricle (RWT), all study subjects were divided into two equal groups of 38 individuals each with RWT>0.42 (left ventricular concentric remodeling) and RWT<0.42 (normal geometry of the left ventricle). The analysis of the data obtained showed relatively larger left cardiac cavities, relatively higher rate of morning rise and a 24-hour variability of mainly systolic blood pressure, the reduced activity of parasympathetic autonomic nervous system, more supraventricular extra systoles mostly at night in patients with concentric left ventricular remodeling, and signs of connective tissue dysplasia in the group of subjects with concentric left ventricular remodeling. More than half of young people with concentric left ventricular remodeling presented signs of the cardiac connective tissue dysplasia, such as mitral valve prolapse and abnormal left ventricular chordae. These features of cardiac structure, ambulatory blood pressure profile, and heart rate variability may be interpreted as signs associated with concentric left ventricular remodeling.