Chronic ischemic artery disease on the background of non-differentiated dysplasia of connective tissue: from phenotypic predictors to hemodynamic peculiarities
Clinical and biochemical, anthropometric, and instrumental examination conducted in full for 120 patients (60 - with the syndrome of non-differentiated dysplasia of connective tissue (NDCT) and 60 - without NDCT) with chronic forms of coronary artery disease (CCAD). Dysplastic stigmas such as radial-lacunar iris of the eye, diagonal earlobe crease, "blue sclera" symptom and anomalies of the dentition have been identified as phenotypic predictors of unfavorable CCAD course on the background of NDCT. Predominant grade II left ventricular diastolic dysfunction (LVDD) - pseudonormal - have been found as a peculiarity of intracardiac hemodynamics violations in patients with CCAD on the background of NDCT. Medium strength direct correlation found in patients with NDCT between the number of NDCT phenotypic markers and frequency of detection of grade II LVDD (r=+0,57; p<0.05), paroxysmal supraventricular tachycardia (r=+0,48; p<0.05), atrial fibrillation (r=+0,51; p<0.05). The peculiarity of CCAD course in patients with postinfarction cardiosclerosis on the background of NDCT is reducing of the reparative fibrosis quality, as chronic postinfarction heart aneurysm, severe arrhythmias (paroxysmal supraventricular tachycardia, atrial fibrillation), grade II LVDD, which, however, were associated with lower total cholesterol serum. Found violations of left ventricular diastolic function in patients with CCAD and postinfarction cardiosclerosis on the background of NDCT can be considered as one of the links in the mechanism of adaptation in postinfarction left ventricular remodeling in the further study of peculiarities of connective tissue skeleton of the heart in this category of people.