Changes in the Thickness of the Walls of the Left and Right Ventricles Depending on the Cause of Death in Patients With Arterial Hypertension According to Autopsy Study

Objective: To explore the relationship between changes in the thickness of the walls of the left and right ventricles according to causes of death among people with arterial hypertension according to autopsy data. Design and method: A retrospective study was conducted based on autopsy reports over a period of 16 years. 643 data from autopsy reports were selected for analysis of patients who suffered from arterial hypertension during their lifetime and died suddenly. They did not have any other concomitant diseases leading to cardiac remodeling. The normal wall thickness of the left ventricle was taken as 0.7-1.2 cm, the right ventricle 0.2-0.3 cm. Results: The mean age (Me, IQR; 25th to 75th centiles) was 56 (49-63) years, for men - 54 (48-61, n=372); in women - 59 (50-69, n=255, p<0.001) for 643 autopsy reports submitted from patients with hypertension. The main causes of death among patients with arterial hypertension were acute heart failure, myocardial infarction, acute cerebrovascular accident, which was 98.9% (n=636), and they were taken into account in subsequent calculations when comparing groups. Thus, the groups were divided by cause of death: cardiac and cerebral. In the group, there were 62.5% (n=402) cases of cardiac death and 37.5% (n=241) of cerebral death, age was 58 (50-67) and 52 (46-61), respectively, p<0.001. The thickness of the ventricular wall was determined was determined for cardiac and cerebral causes of death, respectively, for the left ventricle 2.5 (2.0-2.5) and for 1.8 (1.6-2.0) cm and for the right ventricle 0.9 (0.6-1.2) and 0.4 (0.3-0.6) cm. The cardiac death case prevailed over the cerebral one with a more pronounced degree of left ventricular hypertrophy (Chi-square 125.2, df=1, p <0.001), and in the presence of right ventricular hypertrophy 25.6 times higher (95% CI 11.6-52.4), the differences in the group were statistically significant (Chi-square 124.2, df=1, p <0.001). Conclusions: The main cause of death in people with hypertension was the development of heart failure and myocardial infarction. Cardiac causes of death predominated among individuals with more pronounced changes in the left ventricle and in the presence of hypertrophy of the right ventricle.