[Involutive and hypertensive fibrosive transformation of the heart in formation of myocardial dysfunction and chronic heart failure.]

To assess the conjugation of involutive and hypertensive fibrotic transformation of the heart formation with myocardial dysfunction and chronic heart failure (CHF), 30 normotensive individuals and 60 elderly patients with arterial hypertension (AH) (mean age - 66±0,7 years) were examined by echo and dopplercardiography, estimation of the volume fraction of interstitial collagen (VFIC) in the myocardium, serum concentrations of markers of systemic collagenogenesis, using a six-minute walk test. A higher intensity of LV myocardial fibrosis was revealed with a significant increase in the VFIC content in elderly patients with AH compared with normotensive patients, which indicates the predominance of interstitial collagenogenesis over collagenolysis. The increased content of fibrous tissue in myocardial interstitium caused the development of unfavorable types of cardiac remodeling and the progression of diastolic dysfunction, negatively affecting the functional reserve of the circulatory system, as evidenced by negative correlations between the level of the VFIC and the results of a 6-minute walk test: weak in patients with I FC CHF, moderate strength in patients with AH with II FC CHF.