Changes in the arterial bed kinetics in patients with coronary artery disease and arterial hypertension during the development of chronic heart failure

Objective: to identify specific features of biomechanics of the systemic circulation arteries in patients with coronary artery disease and arterial hypertension during the development of chronic heart failure. Materials and methods. We performed examination of 152 patients after myocardial infarction with or without arterial hypertension (AH) and stage I or stage IIA chronic heart failure (CHF), functional class (f.c.) II. All study participants underwent computed sphygmography of the carotid, ulnar, radial, femoral, anterior tibial arteries, and foot arteries at rest. Results. We observed significantly increased duration of the inflow phases in the a.carotis in patients with stage I CHF of II f.c. only in the case of AH. The CHF progression was accompanied by shortening of the inflow phases in all patients. The results of investigation of the peripheral arteries biomechanics demonstrated an increase in the duration of inflow phases and a decrease in the duration of outflow phases along with CHF progression. We also revealed an increased duration of several phases associated with propulsive activity of the arterial wall in patients with AH (mainly with I stage CHF of II f.c.) compared to those with normal blood pressure. The speed and power parameters of the peripheral arteries biomechanics declined along with increasing CHF severity in all patients after myocardial infarction regardless of AH throughout the whole vascular cycle. Patients with AH and stage I CHF of II f.c. were found to have elevated speed and power parameters of the peripheral arteries kinetics during the phases of smooth muscle contractile activity comparing with patients without AH. Conclusions: 1. The changes in the biomechanics of the systemic circulation arteries (detected at the first stages of CHF development and reflecting the process of their remodeling) ensure the adaptive effect in patients with coronary artery disease and arterial hypertension. 2. The CHF progression is associated with impaired propulsive activity of the arterial bed, which increases the severity of clinical manifestations and is an independent mechanism for the development of decompensation.