Гендерные особенности ремоделирования миокарда левого желудочка при хронической сердечной недостаточности

To determine the gender differences in risk factors of left ventricular remodeling in patients with chronic heart failure associated with arterial hypertension and coronary heart disease. Methods. The study included 112 patients aged 45 to 60 years with myocardial scaring after myocardial infarction and functional class I–III of heart failure by NYHA. Patients were distributed to 2 groups: 1st included 60 males (mean age 54.8±3.3 years), 2nd — 52 females (mean age 55.8±3.1 years). To assess the cardiac function, all patients underwent echocardiography (B- and M-modes). Models of left ventricle architectonics were identified according to such parameters as left ventricle wall relative thickness index and left ventricular mass index. Results. Leading causes for heart failure in female patients were hypertension (50% of cases) and ischemic heart disease (23.1% of cases, 79.5% of ischemic heart disease cases were not associated). In males, ischemic heart disease was the leading reason for chronic heart failure (78.3% of cases, among them 80.9% with a history of survived myocardial infarction). In females, chronic heart failure was more often associated with isolated diastolic dysfunction (78.8% of cases versus 65% in males, p <0.05), and left ventricle ejection fraction was stable. Unfavorable types of left ventricle remodeling in terms of prognosis were more common among females, including eccentric left ventricle hypertrophy (67.3% of cases versus 53.3% in males, p <0.05) and concentric left ventricle hypertrophy (21% of cases versus 18.3% in males, p >0.05). Conclusion. There are gender differences in patients with chronic heart failure: prevalence of hypertension in women, and coronary heart disease in men; higher rate of isolated diastolic dysfunction prognostically unfavorable types of left ventricle remodeling (eccentric and concentric left ventricle hypertrophy) in females.