Finding Early Predictors of Myocardial Dysfunction
Condition: Hypertension; Heart Failure
MeSH terms: Hypertension; Heart Failure
Study type: Observational

Summary: 
      The study objective is to clarify the grounds of heart exertional dyspnoea stenocardia in
      patients with well-controlled stage I or II hypertension according to European Society of
      Hypertension, without changes in epicardial coronary arteries in CT coronary angiography and
      normal resting echocardiography result, and to assess of potential early markers of heart
      hypertrophy and failure in patients with hypertension.
    

Detailed description: 
      The study is to allow for identification of patients with hypertension, in whom an early
      introduction of pharmacological treatment of heart failure HF should be considered.
      Evaluation in the detection of asymptomatic myocardial dysfunction will include potential
      heart failure markers such as: cardiotrophin 1, cystatin C, serum syndecan-4, collagen III
      N-terminal propeptide [PIIINP], NT-proBNP, IL1RL1 and modern echocardiography methods in
      order to increase the effectiveness of prevention, diagnosis and treatment optimalization.

      Material and study plan about 100 persons (age 30-70 years old) will be included in the
      study, patients with stage I or II primary hypertension according to the European Society of
      Hypertension: Group A- 15 patients without symptoms of heart failure Group B- 30 patients
      with exertional dyspnoea Group C - 40 patients with overt heart failure

      In group B (patients with exertional dyspnea/stenocardia) we will include only patients who
      have undergone CT coronary angiography without any identified changes in the epicardial
      coronary arteries, which will facilitate answering the presented purpose of research.
      Patients in groups A and B with normal resting echocardiography and treated with a maximum of
      2 antihypertensive drugs (an ACE inhibitor or a sartan as therapy base), according to the
      following regimen:

      ACEI/ARB + diuretic ACEI/ARB + calcium channel antagonist Group C - treatment in accordance
      with the standards for heart failure. Each patient will be informed about the objectives of
      the study and give written consent to participate.

      After signing informed consent patients will have performed the following tests:

        -  Interview and documentation analysis,

        -  Physical examination,

        -  Electrocardiogram

        -  Echocardiography at rest and during submaximal exercise on a bicycle ergometer

        -  Levels of markers: cystatin C, cardiotrophin-1, Procollagen III N-Terminal Propeptide
           (PIIINP), Syndecan 4 (SDC4) and NT-proBNP, IL1RL1. Each patient will be informed about
           the objectives of the study and give written consent to participate.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        persons (age 30-70 years old) will be included in the study, patients with stage I or II
        primary hypertension according to the European Society of Hypertension
      
Biospecimen description: 
      blood plasma
    
Keywords: hypertension, biomarkers, echocardiography, heart failure