Finding Early Predictors of Myocardial Dysfunction in Patients With Hypertension

Finding early predictors of myocardial in patients with hypertension 1. Scientific objective The study objective is to clarify the grounds of heart exertional dyspnoea stenocardial pain in patients with well-controlled stage I or II hypertension according to ESH (European Society of Hypertension), without changes in epicardial coronary arteries in coronary angiography and normal resting echocardiography result, and to assess of potential early markers of heart hypertrophy and failure in patients with hypertension. Characteristics of the final result The study is to allow for identification of patients with hypertension, in whom an early introduction of pharmacological treatment of heart failure 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 propetide \[PIIINP\], MMP-2, MMP-7, MMP-8, MMP-9 and NT-proBNP, modern echocardiography methods and magnetic resonance imaging in order to increase the effectiveness of prevention, diagnosis and treatment optimalization. 2. Project significance Prognosis in heart failure is very serious. It is similar or worse than in advanced cancer. These data indicate an extreme importance of the optimal early causal treatment of hypertension and symptomatic treatment of heart failure early stage in order to prevent the development advanced form of the disease, which has bad prognosis. In clinical practice, patients with well-controlled hypertension often report exercise limitation, exertional dyspnea and/or stenocardial pain which is not reflected in a standard resting echocardiography (normal result), without coronary artery disease data in electrocardiographic stress test and without change in epicardial coronary vessels in coronary angiography. The study is designed to establish the panel of diagnostic tests in patients with hypertension and exertional dyspnoea only, whi