NITRIC OXIDE AND MYOCARDIAL REMODELING IN ARTERIAL HYPERTENSION IN AREAS OF HIGHER ALTITUDES

Aim. To study the influence of nitric oxide (NO) on the types of remodeling of the left ventricle myocardium (LV) and hemodynamics parameters in patients with arterial hypertension (AH), inhabitants of the higher altitudes areas.Material and methods. In high altitudes of Elbrus areas we studied 170 person at the age 37-68 y.o.: 110 patients with AH of various grade and 60 healthy persons. All patients underwent general clinical, instrumental and laboratory investigations. Production of NO was assessed by nitrite- anion NO2- and nitrate-anion NO3- concentration in plasma and erythrocytes by spectral method.Results. Myocardial geometry changes were found in 53% patients with AH, related to the changes of NO metabolites concentration in blood and hemodynamics. NO concentration was decreased by 5% in patients with AH with normal geometry of the LV. Significant decrease of NO was found in the groups of patients with concentric remodeling of the LV and concentric hypertrophy of the LV by 39% and 92%, respectively. Normal production of NO with higher concentration of nitrites in the blood was found in patients with eccentric hypertrophy.Conclusion. In total, the data shows a significant role of NO for the regulation of blood pressure and course of the LV remodeling in AH patients. Under conditions of chronic hypoxia production of NO increases, and that might influence significantly hemodynamics and types of the left ventricle geometry in higher altitudes inhabitants.