CHARACTERISTICS OF THE CHRONIC HEART FAILURE COURSE AND TARGET ORGAN CONDITION IN CARDIORENAL SYNDROME

• Main Authors: I. I. Kolegova, A. I. Chernyavina, N. A. Koziolova
• Format: Article
• Language: Russian
• Published: «FIRMA «SILICEA» LLC 2018-03-01
• Series: Российский кардиологический журнал
• Subjects: chronic heart failure; chronic renal disease
• Online Access: https://russjcardiol.elpub.ru/jour/article/view/2677

Aim. To investigate on the specifics of chronic heart failure (CHF) course and functional remodeling of target organs in coronary heart disease (CHD) patients with chronic renal disease (CRD).Material and methods. According to the criteria, 162 patients included, with CHD and CHF II-III functional class (FC), selected to 2 equal groups: group 1 — CRD patients, group 2 — with no renal dysfunction. For comparison, the parameters were evaluated that represent the specifics of CHF pathogenesis, structural and functional condition of the left heart chambers, of arteries and kidneys.Results. The presence of CRD was related to more serious diastolic dysfunction in CHD with CHF patients (p<0,001 for E/e’ and mean e’) and increase of the left ventricle myocardial mass index (p=0,0043) and preserved ejection fraction of the left ventricle (p<0,001), followed by higher level of N-terminal natriuretic peptide (p=0,018). More significant filtration disorders of kidneys (p<0,001 for all values) with no progression of tubular disorders (p=0,078), more prominent arterial stiffness  (p<0,001 by index CAVI1 and augmentation index) with the increase of TIMP-1 (p=0,002) registered in CHD with CHF plus CRD patients.Conclusion.  With CRD, there is more serious CHF with preserved LV EF and diastolic dysfunction. Target organ remodeling in CHD and CHF with CRD patients was characterized by some specific regularities of structural and functional condition of the heart, of arterial vessels and kidneys, and of one of the mechanisms there was a disordered balance of collagenolysis towards risk of fibrosis.