Clinical and instrumental characteristics of patients with chronic heart failure and reduced left ventricular ejection fraction depending on renal dysfunction

August 22, 2018
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Aim — to compare clinical and instrumental indicators of patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (LVEF) with renal dysfunction (RD) and without it. Materials and methods. 134 patients with CHF and LVEF were examined. Patients were divided into 2 groups by the the glomerular filtration rate (GFR): the first — <60 ml/min/1.73 m², the second — ≥60 ml/min/1.73 m². GFR was estimated using the CKD-EPI equation. Daily microalbuminuria and urinary albumine/creatinine ratio were determined. Definitions of levels of blood urea nitrogen, uric acid, interleukin (IL)-6, NTproBNP and citrulin were performed. The functional capabilities of the patients were determined using a 6-minute walk test. The quality of life was assessed using the Minnesota Questionnaire. The level of household physical activity was assessed using the Duke University questionnaire. Ultrasound diagnosis of the vasodilating function of the brachial endothelium was performed using a test with reactive hyperemia. Results and conclusions. Among patients with CHF and reduced LVEF, RD was observed in 39.5%. In the group with RD: women, patients with III–IV NYHA class and comorbidities, such as arterial hypertension, stable coronary disease and diabetes, were more common. Patients with RD showed low level of physical activity, worse results with 6-minute walk test, worse quality of life and at the same time were characterized by significantly high levels of uric acid, IL-6 and citrulline. Between groups of patients with and without RD, there were no significant differences in hemodynamic parameters (heart rate, systolic blood pressure, LV EF, end-diastolic volume/body surface area), levels of potassium and NTproBNP, microalbuminuria and endothelium-dependent dilation.

L.G. Voronkov, G.E. Dudnik, A.V. Lyashenko, L.S. Mkhitaryan, T.I. Gavrilenko, G.V. Ponomaryova

Key words: chronic heart failure, renal dysfunction, glomerular filtration rate, microalbuminuria.

Published: 05.09.2018

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