Cardiorenal syndrome in patients with acute heart attack

• Kozyrev Oleg A.
• Bazina Irina B.
• Zubkov Sergey K.
• Litvinova Irina A.
• Levina Yulia V.
• Zagubnaya Ekaterina S.
• Kirsova Maria P.

Abstract

The relationship between renal dysfunction, glomerular filtration rate (GFR) and the occurrence of acute coronary events, including myocardial infarction (MI), has now been established. Combined heart and kidney disorders are now classified as cardiorenal syndrome (CRS).

The aim of the study was to identify the features of the course of cattle in patients with MI depending on risk factors, localization of the lesion and age of patients.

Material and methods. Patients with MI of different localization were examined. Biochemical blood tests were performed in a centralized laboratory with the calculation of GFR. Echocardiography was performed on the device VIVID E9 (JE) (USA). AH patients underwent coronary angiography and coronary stenting. Statistical processing was carried out in the program Statistica 8.0 (Russia). Results. 100 patients with MI were examined (men - 66%, women - 34%). Repeated MI was detected in 8% of cases, primary - in 92%; anterior MI was diagnosed in 46% of cases, lower - in 54%. Patients under 45 years were 9%, after 45 years - 91%. Arterial hypertension was observed in 92% of patients, diabetes meUitus - in 42%. In patients with MI, increased levels of total cholesterol (HC), low-density lipoprotein cholesterol (LDL cholesterol), lactate dehydrogenase (LDH), glucose, and decreased GFR were revealed. An inverse correlation was found between GFR and LDH (p<0.05). Probably, LDH level is an indicator not only of muscle tissue damage, but also serves as a marker of kidney damage. The role of dyslipidemia as an independent marker of risk of kidney damage requires further study. We found an inverse correlation between total cholesterol (OH) and GFR (p<0.0001), LDL cholesterol and GFR (p<0.0001). The inverse correlation between

Oh and ejection fraction (LV) of the Left ventricle (p<0.0001), direct correlation between OH and dimensions (p<0.001), OH and end-diastolic dimensions (CDR) of the LV (p<0.0005), OH and end-systolic dimensions (CSR) of the LV (p<0.0001) OH and thickness of the interventricular septum (TMJ) (p<0.0001), OH and thickness of the posterior wall LV (p<0.0001). The level of LDL C was inversely correlated with LV Fv (p<0.0001) and LV CDR (p<0.0001), a direct relationship between LDL C and TZSLH (p<0.002), LDL C (p<0.005) was found. Significant differences were obtained, indicating more significant violations of kidney function in diabetes meUitus (p<0.005). It was revealed that GFR in young patients was significantly higher than in patients older than 45 years (p<0.0005). There were no significant differences in GFR in the anterior and inferior MI (p>0.5). At primary MI GFR was 94.9±11.8 mL/min, at repeated MI-74.25±13.6 mL/min (p<0.05).

Conclusion. In patients with acute MI, there is a relationship between blood biochemical parameters, GFR and echocardiography results. A tendency to increase GFR after coronary stenting was found. The obtained data indicate the mutual influence of cardiovascular and renal pathology on each other, which should be taken into account in the tactics of treatment of patients.

Keywords:cardiorenal syndrome, myocardial infarction, glomerular filtration rate

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