ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 21 of 61
JMBS 2019, 4(5): 142–148
Clinical Medicine

Factors Associated with the Development of Cardiorenal Syndrome Type 2 in Chronic Heart Failure and Preserved Contractional Function of the Left Ventricle

Lazidi E. L., Rudyk Iu. S.

The purpose of the study was to investigate and evaluate the factors associated with type 2 cardiorenal syndrome in chronic heart failure and preserved contractional function of the left ventricle. Material and methods. The prospective study included 146 people with chronic heart failure and preserved contractional function (114 women (78.0%) and 62 men (22.0%), the average age was 62.0 ± 12.3 years). We used clinical, functional, instrumental and laboratory methods. Glomerular rate filtration was assessed according to the Cockroft-Golt formula. Reduced renal function was considered in cases with glomerular rate filtration less than 60 ml/min/m2. For statistical analysis we used software Statistica for Windows version 7.0 (Stat Soft inc., USA). Parameters are presented as mean ± standard deviation. The risk assessment for adverse event presents as absolute and relative risks and odds ratios; differences were statistically significant with p<0.05. Results and discussion. The obtained results showed that factors associated with a high risk of cardiorenal syndrome in patients with heart failure were in the age older than 55 years and body mass index more than 32 kg/m2, (p<0.05). The probable inverse correlation between kidney function and body mass index in patients with heart failure was (r = -0.32, p<0.05). The increase in the expected frequency from 0.2 to 0.48 events in the form of chronic kidney disease by 100.0 cases of chronic heart failure was set by the body mass index when it increased from 24.9 to 30.0 units. The laboratory parameters proved that the risk low glomerular rate filtration rate in patients with cardiorenal syndrome was obtained at lower level of hemoglobin and hematocrit (p<0.05). Hyponatremia was set as probable risk factor for type 2 cardiotrenal syndrome in patients with chronic heart failure: 36.0% versus 24.0%, relative risk - 1.47 [1.01-2.14] (p<0.05), odds ratio - 1.74 [1.0-3.02] (p <0.05). Reducing sodium levels below 125 mmol/l increased the risk of cardiorenal syndrome by 47.0%. Conclusions. The study established direct correlation between the aldosterone and creatinine level (r = 0.41, p<0.05), reversed relationship between aldosterone and glomerular filtration rate (r = -0.43, p<0.05). We propose linear regression model between the content of proBNP, aldosterone and the level of glomerular filtration rate in patients with glomerular filtration rate: aldosteron = 68.08-GFR*0,049; NTproBNP = 399.35-GFR * 0.151.

Keywords: chronic heart failure, cardiorenal syndrome, glomerular rate filtration

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