Role of conservative treatment of chronic venous insufficiency for regression of the features of desadaptive cardiac remodeling in patients with comorbid obesity
I N Leukhnenko , O V Teplyakova , I F Grishina
Kazan medical journal ›› 2017, Vol. 98 ›› Issue (2) : 165 -171.
Role of conservative treatment of chronic venous insufficiency for regression of the features of desadaptive cardiac remodeling in patients with comorbid obesity
Aim. To evaluate the influence of conservative treatment tactics for chronic venous insufficiency on the processes of cardiac remodeling in patients with comorbid obesity.
Methods. 32 males with obesity class 1 (BMI 32.57±2.25 kg/m2) at the age of 40.7±11.5 years and with clinical and instrumental signs of chronic venous insufficiency were divided into 2 groups: patients from group 1 (n=14) followed the recomendations to wear compression stockings and to use hesperidin + diosmin 500 mg twice a day, and the patients from group 2 (n=18) did not follow those recommendations. All patients had echocardiography performed before the treatment and 2 months after the first visit. For the evaluation of echocardiographic dynamics paired Student’s t-test was used.
Results. After 2 months statistically significant dynamics of the following echocardiographic findings was revealed: in group 1 index of eccentric left ventricular shape increased from 0.94±0.06 to 1.01±0.03, in group 2 - from 0.96±0.08 to 0.97±0.07 (р=0.023). In group 1 tricuspid annular plane systolic excursion decreased from 30.07±5.31 to 26.64±4.14 mm, in group 2 - from 29.6±4.72 to 29.88±6.04 mm (р=0.008), and the right atrial volume in group 1 decreased from 53.57±11.48 to 46.64±13.18 ml, in group 2 - from 52.77±11.27 to 51.38±8.54 ml (р=0.044). In group 1 statistically significant trend to decreased ratio of maximal velocity of RV early diastolic filling to maximum diastolic tricuspid valve lateral annular velocity was revealed (from 4.75±1.35 to 4.25±1.23 cm/sec) compared to group 2 (from 4.79±1.62 to 4.75±1.58 cm/sec; р=0.076).
Conclusion. Conservative treatment of chronic venous insufficiency in patients with obesity is associated with indirect indicators of decreasing volume overload of the heart and can influence positively on heart geometry leading to regression of spheric LV remodeling and decrease of RA volume.
venous insufficiency / obesity / cardiac remodeling / prevention / compliance
Leukhnenko I.N., Teplyakova O.V., Grishina I.F.
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