russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLCrussjcardiol-2038Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESКОНЦЕНТРИЧЕСКОЕ РЕМОДЕЛИРОВАНИЕ МИОКАРДА У БОЛЬНЫХ С ХРОНИЧЕСКОЙ ПОЧЕЧНОЙ НЕДОСТАТОЧНОСТЬЮCONCENTRIC MYOCARDIAL REMODELING IN CHRONIC RENAL FAILUREВолгинаГ. В.VolginaG. V.

Кафедра внутренних болезней №3 

ДудаевВ. А.DudayevV. A.

Кафедра внутренних болезней №3 

Московский государственный медико-профилактический университетRussian Federation200128102001052125Copyright © Волгина Г.В., Дудаев В.А., 20012001Волгина Г.В., Дудаев В.А.Volgina G.V., Dudayev V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/2038

Увеличение массы миокарда левого желудочка (МЛЖ) и изменение его геометрической модели повышают риск кардиоваскулярных заболеваний и ухудшают прогноз больных с хронической почечной недостаточностью (ХПН).

Целью исследования явилось изучение механизмов раннего ремоделирования миокарда при различных стадиях ХПН. Исследование включало 106 больных в возрасте 44,9±13,6 лет с недиабетической ХПН (74 больных додиализной и 32 больных диализной ХПН) и нормальной массой левого желудочка (МЛЖ). Концентрическое ремоделирование миокарда (К-ремоделирование) установлено по данным эхокардиографического исследования при наличии нормальной МЛЖ и увеличении относительной толщины стенок ЛЖ. Распространение К-ремоделирования миокарда составило 36,7% случаев при додиализной и 63,3% - при диализной ХПН. Факторами риска К-ремоделирования миокарда у больных с ХПН были: возраст, женский пол при отсутствии физиологического снижения АД ночью, анемия, более тяжелое нарушение функции почек, большая длительность артериальной гипертензии и наличие систолической и диастолической артериальной гипертензии. У больных с диализной ХПН при К-ремоделировании миокарда имело место большее междиализное увеличение веса, по сравнению с группой пациентов с неизмененной геометрией ЛЖ. 

Increased LV myocardial mass (LVM) and alteration of its geometric model further cardiovascular risk and deteriorate prognosis in chronic renal failure (CRF).

The aim of the study was to observe the fine mechanism of early myocardial remodeling on various stages of CRF. The study included 106 patients aged 44,9±13,6 with non-diabetic CRF (74 pre-dialysis and 32 with dialysis-stage CRF) and normal LVM. Concentric myocardial remodeling (C-remodeling) was established with echocardiography with normal LVM and increased relative width of LCV walls. C-remodeling accounted for 36,7% cases in pre-dialysis and 63.3% in dialysisstage CRF. The risk factors for C-remodeling were: age, female sex with no physiological nocturnal fall in blood pressure, anemia, a more severe renal function impairment, a longer history of arterial hypertension, systolic and diastolic arterial hypertension. A greater mass increase between dialysis sessions was observed in patients with dialysis-stage CRF as compared to those with normal LV geometry. 

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The authors declare that there are no conflicts of interest present.