Finding Early Predictors of Myocardial Dysfunction in Patients With Hypertension

The concept and plan of study 1. The attempt 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. 2. MRI evaluation of coronary microcirculation and endothelial function assessed by flow-dependent vasodilation in hypertensive patients with and without heart failure symptoms. 3. Comparison of modern echocardiographic methods and magnetic resonance imaging in the diagnosis of hypertensive patients with and without overt heart failure. 4. Cystatin C as a new marker of organ damage in patients with hypertension and comparison of cystatin C with GFR assessed by MDRD and Cockcroft-Gault creatinine clearance on as renal function assessment indicators in patients with hypertension. 5. Evaluation of new markers - cardiotrophin 1 and cystatin C, serum syndecan-4, collagen III N-terminal propetide \[PIIINP\], MMP-2, MMP-7,MMP-8, MMP-9 and NT-proBNP in the early diagnosis of heart failure. 6. Potential markers of heart failure, modern echocardiography methods and magnetic resonance imaging in the detection of asymptomatic myocardial dysfunction in order to increase the effectiveness of prevention and treatment. 7. Searching for the relationship between the type of hypertension (dipper or non-dipper) and the development of heart failure symptoms, and whether there are differences between the echocardiographic images of these patients? 8. Selection of patients with hypertension, in whom an early introduction of pharmacological treatment of heart failure should be considered. 9. The study will also help answer the following questions: (a) Which parameters best assess the overall cardiovascular risk? and (b) When the treatment of heart failure in patients with hypertension should start. The measurable effect of this research besides cognitive is to the possibility of reducing the proportion of patients who come to overt heart failure connected with hypertension through the optimization of preventive, diagnostic methods and to determine the optimum treatment in these patients.