FUNCTIONAL STATUS OF HEART AND KIDNEYS AND CARDIO-RENAL INTERACTIONS IN PATIENTS AFTER CORONARY REVASCULARISATION INTERVENTION
Abstract
Aim. To assess cardio-renal interactions and the functional status of heart and kidneys in patients with acute myocardial infarction (AMI) who underwent the post-AMI coronary revascularisation. Material and methods. In total, 100 men, aged 45–60 years, were examined, including 50 AMI patients who underwent the revascularisation surgery. Cardiac structure and function, as well as excretory, glomerular, and tubular renal functions, were assessed. Results. Patients who underwent revascularisation demonstrated lower creatinine levels. In this group, the prevalence of the serum creatinine concentration >115 μmol/l and glomerular filtration rate (GFR) < 60 ml/min was significantly lower than in the patients treated conservatively. Urine levels of β2-microglobulin, reflecting the tubular renal function, were significantly lower in AMI patients after revascularisation. In addition, the revascularisation group demonstrated an improvement in cardio-renal interactions, compared to the conservative treatment group. Conclusion. Among AMI patients who underwent coronary revascularisation, in comparison to the patients treated conservatively, there was an improvement in cardio-renal interactions and a positive dynamics in both cardiac structure and function and renal functional status. In the revascularisation group, renal function parameters were significantly associated with the parameters of cardiac structure and function, which confirmed the existence of cardio-renal interactions.
About the Authors
M. E. Statsenko
Volgograd State Medical University, Volgograd
Russian Federation
Russian Federation
D. V. Bolotov
Volgograd State Medical University, Volgograd
Russian Federation
Russian Federation
References
1. Silber S., Albertsson P., Aviles F. F. et al. Guidelines for percutaneous coronary intervention. The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology. Eur. Heart J. 2005; 26:804–47.
2. Akchurin R. S., Shiryaev A. A., Lepilin M. G. et al. Modern surgery of coronary arteries. Cardiologicheskii vestnik, 2010; 1:45–9. Russian (Акчурин Р. С., Ширяев А. А., Лепилин М. Г. и др. Современная хирургия коронарных артерий. Кардиологический вестник. 2010; 1:45–9).
3. Donald E., Amit G., Donald S. Daim Five-Year Clinical Outcomes From Second-Generation Coronary Stent Trial. Circulation 2004; 110:1226–30.
4. Kazakova R. I. Left ventricle pump function, functional condition and survival rate of patients with coronary artery disease at the long-term period after aortocoronary bypass grafts (Ten years’ follow-up trial). Author’s abstract. 2003. Russian (Казакова И. Г. Сократительная функция левого желудочка, функциональное состояние и выживаемость больных ишемической болезнью сердца в отдаленном периоде после коронарного шунтирования (Проспективное десятилетнее наблюдение): Автореф. дис. канд. мед. наук. 2003).
5. Bokeriya L. A., Alshibaya M. M., Vischipanov A. S. et al. Long-term outcome of the surgical treatment of coronary artery disease at a young age persons. Annals of Surgery, 2009; 6:63–6. Russian (Бокерия Л. А., Алшибая М. М., Вищипанов А. С. и др. Отдаленные результаты хирургического лечения ишемической болезни сердца у лиц молодого возраста. Анналы хирургии. 2009; 6:63–6).
6. Kuzmin O. B. Chronic kidney disease and cardiovascular system condition. Nephrology. 2007; 11:1:28–9. Russian (Кузьмин О. Б. Хроническая болезнь почек и состояние сердечно-сосудистой системы. Нефрология. 2007; 11; 1:28–9).
7. Statsenko M. E. The efficiency of chronic heart failure treatment at the elderly persons depending on a kidneys functional condition. Russ J Cardiol, 2007; 2: 30–5. Russian (Стаценко М. Е. и др. Эффективность лечения хронической сердечной недостаточ-ности у лиц старшей возрастной группы в зависимости от функционального состоя-ния почек. Российский кардиологический журнал. 2007; 2: 30–5).
8. Dyudjikov A. A., Terentiev V. P., Poddubniy A. V. Assessment of “ kidneys” risk factors and parameters of a coronary plaque influence on a cardiovascular forecast at patients with coronary artery disease. Cardiovascular therapy and prevention, 2011; 4:59–62. Russian (Дюжиков А. А., Терентьев В. П., Поддубный А. В. и др. Оценка влияния “почечных” факторов риска и параметров коронарной бляшки на сердечнососудистый прогноз
9. у больных с ишемической болезнью сердца. Кардиоваскулярная терапия и профилактика. 2011; 4:59–62).
10. Robert A. M., Brown J. R., Sidhu M. S. et al. The evaluation of creatinine clearance, estimated glomerular filtration rate and serum creatinine in predicting contrast-induced acute kidney injury among patients undergoing percutaneous coronary intervention. Cardiovasc. Revasc. Med. 2012; 13 (1):3–10.
11. Hafiz A. M., Jan M. F., Mori N. et al. Contemporary clinical outcomes of primary percutaneous coronary intervention in elderly versus younger patients presenting with acute ST-segment elevation myocardial infarction. J. Interv. Cardiol. 2011;24 (4):357–65.
12. Thourani V. H., Sarin E. L., Keeling W. B. et al. Long-term survival for patients with preoperative renal failure undergoing bioprosthetic or mechanical valve replacement. Ann. Thorac. Surg. 2011; 91 (4):1127–34.
13. Chvokov A. V., Morozov Yu. A., Urjuzhnikov V. V. Kidney function after bilateral mammary arteries bypass grafts at the patients with coronary artery disease and diabetes. Cardiology and cardiovascular surgery, 2012; 1:94–7. Russian (Чвоков А. В., Морозов Ю. А., Урюжников В. В. Функция почек после бимаммарокоронарного шунтирования у больных ишемической болезнью сердца и сахарным диабетом. Кардиология и сердечно-сосудистая хирургия. 2012; 1:94–7).
14. Functional condition of kidneys and cardiovascular risk forecast. The Russian Guidelines developed by the Committee of Russian national scientific organization of cardiologists and Scientific organization of nephrologists. Cardiovascular therapy and prevention, 2008; 7 (6): Suppl. 3, 41 с. Russian (Функциональное состояние почек и прогнозирование сердечно-сосудистого риска. Российские рекомендации разработаны Комитетом экспертов Всероссийского научного общества кардиологов и Научным обществом нефрологов России. Кардиоваскулярная терапия и профилактика, 2008; 7 (6): Приложение 3, 41 с.).
15. Russian national scientific organization of cardiologists and Committee of cardiovascular insufficiency guidelines for chronic heart failure diagnostics and treatment (the third revision). Heart failure, 2010; 1:3–63. Russian (Национальные рекомендации ВНОК и ОССН по диагностике и лечению ХСН (третий пересмотр). Сердечная Недостаточность. 2010; 1:3–63).
16. Arnlov J., Evans J. C., Meigs J. B. et al. Low-grade albuminuria and incidence of cardiovascular disease events in nonhypertensive and nondiabetic individuals: the Framingham Heart Study. Circulation. 2005; 112 (7): 969–75.
Review
For citations:
Statsenko M.E., Bolotov D.V. FUNCTIONAL STATUS OF HEART AND KIDNEYS AND CARDIO-RENAL INTERACTIONS IN PATIENTS AFTER CORONARY REVASCULARISATION INTERVENTION. Russian Journal of Cardiology. 2012;(6):39-44. (In Russ.)
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