Russian Heart Failure Journal 2007year Radionuclide methods in evaluating interrelations between disorders of central hemodynamics and renal function in patients with circulatory insufficiency
Radionuclide methods in evaluating interrelations between disorders of central hemodynamics and renal function in patients with circulatory insufficiency
Vesnina Zh. V., Pekarskaya M. V., Pavlyukova E. N., Lishmanov Yu. B.
Urgency. Renal dysfunction is considered an independent RF for an unfavorable course of IHD and mortality in patients with progressive HF. At the same time studies focused on effects of disturbed cardiopulmonary hemodynamics on the renal function in patients with CF are scanty and controversial. Aim. To study the interrelation between disorders of central hemodynamics and renal function in patients with HF using radionuclide techniques. Material and methods. 37 patients with IHD (mean age 52.43±1.29 years) and II–II NYHA class HF were evaluated. All patients underwent radiocardiopulmonography (RCPG) with 99mТс-pertechnetate and dynamic radionuclide renoscintigraphy with 99mТс-DMCA for calculation of cardiopulmonary hemodynamic parameters and renal function. Results. The evaluated patients had abnormalities in most cardiopulmonary hemodynamic parameters, which indicated reduction of both left and right ventricular contractility with development of pulmonary hypertension. Renal dysfunction was revealed in 73% of evaluated patients, and it was evident as reduced glomerular filtration rate in one or both kidneys and/or prolonged elimination half-time of the marker from renal parenchyma. The impaired renal filtration and elimination directly correlated with reduced heart minute volume (MV), cardiac index (CI) and circulation efficiency coefficient (CEC), which allows considering the reduced cardiac output (CO) a major pathogenetic factor of renal dysfunction in patients with HF. It was also shown that disorders of pulmonary circulation closely negatively correlated with the reduced renal filtration ability.