Факторы риска развития диастолической дисфункции миокарда левого желудочка у пациентов с хронической болезнью почек
Факторы риска развития диастолической дисфункции миокарда левого желудочка у пациентов с хронической болезнью почек
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Аннотация
Цель исследования. Изучить частоту и факторы риска развития диастолической дисфункции (ДД) левого желудочка (ЛЖ) сердца у пациентов с хронической болезнью почек (ХБП).
Материалы и методы. В исследование включены 225 пациентов с I–Ⅴ стадиями ХБП недиабетической этиологии (медиана возраста 47,0 лет, 50,2% женщин). В зависимости от степени снижения скорости клубочковой фильтрации (СКФ) всех больных разделили на 3 группы. Группу 1 (n=70) составили пациенты с СКФ 89–45 мл/мин/1,73 м2, группу 2 (n=120) – больные с СКФ 44–15 мл/мин/1,73 м2, группу 3 (n=35) – пациенты с СКФ <15 мл/мин/1,73 м2. В контрольную группу включены лица без ХБП. Всем больным проведено общеклиническое обследование и трансторакальное эхокардиографическое исследование; у 86 пациентов определили уровень цистатина C в сыворотке крови.
Результаты. Гипертрофия ЛЖ (ГЛЖ) сердца выявлена у 87 (38,7%) из 225 больных ХБП. Гипертрофический тип (I тип) ДД миокарда ЛЖ диагностирован у 90 (41,4%) из 225 пациентов с ХБП. Частота ДД миокарда ЛЖ I типа нарастала при снижении СКФ, составив 30, 40 и 60% в группах 1, 2 и 3 соответственно. Систолическая функция миокарда ЛЖ сердца оказалась сохранной. Пациенты с ДД были старше, у них был выше индекс массы тела (ИМТ), более выраженное снижение СКФ, более высокий уровень фибриногена. У них чаще выявляли ГЛЖ. Уровень цистатина C по мере ухудшения функции почек повышался, однако при сравнении средних уровней цистатина C у пациентов с наличием/отсутствием ДД в группах, выделенных в зависимости от стадии ХБП, статистически значимых различий не обнаружено. По данным многофакторного анализа, независимым предиктором ДД оказался возраст (отношение шансов 1,106; 95% доверительный интервал 1,057–1,157; р=0,00001).
Заключение. ДД миокарда ЛЖ выявляется в среднем у 40% пациентов с ХБП, частота ее развития увеличивается по мере прогрессирования дисфункции почек. На развитие ДД оказывают влияние традиционные факторы сердечно-сосудистого риска (возраст, ИМТ), а также снижение СКФ и тесно с этим связанное структурное ремоделирование миокарда ЛЖ.
Ключевые слова: диастолическая дисфункция миокарда левого желудочка, хроническая болезнь почек.
Materials and methods. The study included 225 patients with stage I-CKD of non-diabetic etiology (median age 47.0 years, 50.2% of women). Depending on the degree of decrease in the glomerular filtration rate (GFR), all patients were divided into 3 groups. Group 1 (n=70) consisted of patients with GFR 89–45 ml / min / 1.73 m2, group 2 (n=120) – patients with GFR 44–15 ml / min / 1.73 m2, group 3 (n=35) – patients with GFR <15 mL / min / 1.73 m2. The control group includes persons without CKD. All patients underwent general clinical examination and transthoracic echocardiography; in 86 patients the level of cystatin C in the blood serum was determined.
Results. Hypertrophy of the left ventricle (LVH) of the heart was detected in 87 (38.7%) of 225 patients with CKD. Hypertrophic type (type I) of myocardial DD is diagnosed in 90 (41.4%) of 225 patients with CKD. The incidence of myocardial left ventricular dysfunction of the 1st type increased with a decrease in GFR, amounting to 30, 40 and 60% in groups 1, 2 and 3, respectively. The systolic function of the left ventricular myocardium was preserved. Patients with DD were older, they had a higher body mass index (BMI), a more pronounced decrease in GFR, a higher level of fibrinogen. They were more likely to have LVH. The level of cystatin C as the kidney function worsened, but when comparing the mean levels of cystatin C in patients with the presence / absence of DD in the groups isolated depending on the stage of CKD, no statistically significant differences were found. According to the multivariate analysis, the independent predictor of DD was the age (odds ratio 1.106, 95% confidence interval 1.051–1.157, p=0.00001).
The conclusion. DD of the myocardium of the LV is detected on average in 40% of patients with CKD, the frequency of its development increases with the progression of renal dysfunction. The development of DD is influenced by traditional factors of cardiovascular risk (age, BMI), as well as the decline in GFR and closely related structural remodeling of LV myocardium.
Keywords: diastolic left ventricular myocardium dysfunction, chronic kidney disease.
Материалы и методы. В исследование включены 225 пациентов с I–Ⅴ стадиями ХБП недиабетической этиологии (медиана возраста 47,0 лет, 50,2% женщин). В зависимости от степени снижения скорости клубочковой фильтрации (СКФ) всех больных разделили на 3 группы. Группу 1 (n=70) составили пациенты с СКФ 89–45 мл/мин/1,73 м2, группу 2 (n=120) – больные с СКФ 44–15 мл/мин/1,73 м2, группу 3 (n=35) – пациенты с СКФ <15 мл/мин/1,73 м2. В контрольную группу включены лица без ХБП. Всем больным проведено общеклиническое обследование и трансторакальное эхокардиографическое исследование; у 86 пациентов определили уровень цистатина C в сыворотке крови.
Результаты. Гипертрофия ЛЖ (ГЛЖ) сердца выявлена у 87 (38,7%) из 225 больных ХБП. Гипертрофический тип (I тип) ДД миокарда ЛЖ диагностирован у 90 (41,4%) из 225 пациентов с ХБП. Частота ДД миокарда ЛЖ I типа нарастала при снижении СКФ, составив 30, 40 и 60% в группах 1, 2 и 3 соответственно. Систолическая функция миокарда ЛЖ сердца оказалась сохранной. Пациенты с ДД были старше, у них был выше индекс массы тела (ИМТ), более выраженное снижение СКФ, более высокий уровень фибриногена. У них чаще выявляли ГЛЖ. Уровень цистатина C по мере ухудшения функции почек повышался, однако при сравнении средних уровней цистатина C у пациентов с наличием/отсутствием ДД в группах, выделенных в зависимости от стадии ХБП, статистически значимых различий не обнаружено. По данным многофакторного анализа, независимым предиктором ДД оказался возраст (отношение шансов 1,106; 95% доверительный интервал 1,057–1,157; р=0,00001).
Заключение. ДД миокарда ЛЖ выявляется в среднем у 40% пациентов с ХБП, частота ее развития увеличивается по мере прогрессирования дисфункции почек. На развитие ДД оказывают влияние традиционные факторы сердечно-сосудистого риска (возраст, ИМТ), а также снижение СКФ и тесно с этим связанное структурное ремоделирование миокарда ЛЖ.
Ключевые слова: диастолическая дисфункция миокарда левого желудочка, хроническая болезнь почек.
________________________________________________
Materials and methods. The study included 225 patients with stage I-CKD of non-diabetic etiology (median age 47.0 years, 50.2% of women). Depending on the degree of decrease in the glomerular filtration rate (GFR), all patients were divided into 3 groups. Group 1 (n=70) consisted of patients with GFR 89–45 ml / min / 1.73 m2, group 2 (n=120) – patients with GFR 44–15 ml / min / 1.73 m2, group 3 (n=35) – patients with GFR <15 mL / min / 1.73 m2. The control group includes persons without CKD. All patients underwent general clinical examination and transthoracic echocardiography; in 86 patients the level of cystatin C in the blood serum was determined.
Results. Hypertrophy of the left ventricle (LVH) of the heart was detected in 87 (38.7%) of 225 patients with CKD. Hypertrophic type (type I) of myocardial DD is diagnosed in 90 (41.4%) of 225 patients with CKD. The incidence of myocardial left ventricular dysfunction of the 1st type increased with a decrease in GFR, amounting to 30, 40 and 60% in groups 1, 2 and 3, respectively. The systolic function of the left ventricular myocardium was preserved. Patients with DD were older, they had a higher body mass index (BMI), a more pronounced decrease in GFR, a higher level of fibrinogen. They were more likely to have LVH. The level of cystatin C as the kidney function worsened, but when comparing the mean levels of cystatin C in patients with the presence / absence of DD in the groups isolated depending on the stage of CKD, no statistically significant differences were found. According to the multivariate analysis, the independent predictor of DD was the age (odds ratio 1.106, 95% confidence interval 1.051–1.157, p=0.00001).
The conclusion. DD of the myocardium of the LV is detected on average in 40% of patients with CKD, the frequency of its development increases with the progression of renal dysfunction. The development of DD is influenced by traditional factors of cardiovascular risk (age, BMI), as well as the decline in GFR and closely related structural remodeling of LV myocardium.
Keywords: diastolic left ventricular myocardium dysfunction, chronic kidney disease.
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5. [Mareev VYu, Fomin IV, Ageev FT, Arutyunov GP, Begrambekova YuL, Belenkov YuN, Vasyuk YuA, Galyavich AS., Garganeeva AA, Gendlin GE, Gilyarevsky SR, Glezer M G, Drapkina OM, Duplyakov DV, Kobalava Zh D, Koziolova NA, Lopatin YuM, Mareev YuV, Moiseev VS, Nedoshivin AO, Perepech N.B, Sitnikova MYu, Skibitsky VV, Tarlovskaya EI, Chesnikova AI, Shlyakhto EV. Clinical guidelines. Chronic heart failure (CHF). Serdechnaya Nedostatochnost'. 2017;18(1):3-40 (In Russ.)]. https://doi.org/10.18087 /rhfj.2017.1.2346
6. Harnett JD, Foley RN, Kent GM, Barre E, Murray D, Parfrey P. Congestive heart failure in dialysis patients: prevalence, incidence, prognosis, and risk factors. Kidney Int. 1995;47:884-90. https://doi.org/ 10.1038/ki.1995.132
7. Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A, Gong Y, Liu PP. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med. 2006;355:260-69. https://doi.org/10.1056/ NEJMoa051530
8. Herget-Rosenthal S, Bökenkam A, Hofmann W. How to estimate GFR–serum creatinine, serum cystatin C or equations? Clin Biochem. 2007;40(3-4):153-61. https://doi.org/10.1016/j.clinbiochem.2006. 10.014
9. [Kayukov IG, Smirnov AV, Emanuel VL. Cystatin C in current medicine. Nefrologiya. 2012;16(1):22-39 (In Russ.)].
10. Moran A, Katz R, Smith NL, Fried L, Sarnak M, Seliger S, Psaty B, Siscovick D, Gottdiener J, Shlipak M. Cystatin C concentration as a predictor of systolic and diastolic heart failure. J Card Fail. 2008;14:19-26. https://doi.org/10.1016/j.cardfail.2007.09.002
11. Ix JH, Shlipak MG, Chertow GM, Ali S, Schiller N, Whooley M. Cystatin C, Left Ventricular Hypertrophy, and Diastolic Dysfunction: Data From the Heart and Soul Study. J Card Fail. 2006;12(8):601-07. https://doi.org/10.1016/j.cardfail.2006.07.005
12. [Shvetsov MY. Khronicheskaya bolezn' pochek kak obshhemeditsinskaya problema: sovremennye printsipy nefroprofilaktiki i nefroprotektsii. Consilium Medicum. 2014;17(7):51-64 (In Russ.)].
13. Stevens P, Levin A. Evaluation and Management of Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2012 Clinical Practice Guideline. Ann Intern Med. 2013;158(11):825-31. https://doi.org/1010.7326/0003-4819-158-11-201306040-00007
14. Sidmal PS, Mallikarjun HP, Shekarappa KC. Pattern and severity of left ventricular diastolic dysfunction in early and end stage renal disease patients with or without dialysis in rural population in South India. International J Biomed Res. 2015;6(08):546-53. https://doi.org/ 10.7439/ijbr
15. Farshid A, Pathak R, Shadbolt B, Arnolda L, Talaulikar G. Diastolic function is a strong predictor of mortality in patients with chronic kidney disease. BMC Nephrology. 2013;14:280. http://dx.doi.org/10. 1186/1471-2369-14-280
16. [Shutov AM, Kulikova ES, Ivashkina NI, Kondtatyeva NI. Nephrology and Dialysis. 2001;3(4):422-26 (In Russ.)].
17. Park M, Hsu C-y, Li Y, Mishra RK, Keane M, Rosas SE, Dries D,
Xie D, Chen J, He J, Anderson A, Go A, Shlipak MG. Associations between kidney function and subclinical cardiac abnormalities in CKD. J Am Soc Nephrol. 2012;23:1725-34. http://dx.doi.org/10.1681/ ASN. 2012020145
18. Elloual F, Berkch F, Bayahia R, Benamar L, Cherti M. Comparison of the Effects of Dialysis Methods (Haemodialysis vs Peritoneal Dialysis) on Diastolic Left Ventricular Function Dialysis Methods and Diastolic Function. Open Cardiovasc Med J. 2016;10:171-78. http://dx.doi.org/ 10.2174/1874192401610010171
19. Hayashi SY, Rohani M, Lindholm B, Brodin L-A, Lind B, Barany P, Alvestrand F, Seeberger A. Left ventricular function in patients with chronic kidney disease evaluated by colour tissue Doppler velocity imaging. Nephrol Dial Transplant. 2006;21:125-32. http://dx.doi.org 10.1093/ndt/gfi075
20. Losi MA, Memoli B, Contaldi C, Barbati G, del Prete M, Betocchi S, Cavallaro M, Carpinella G, Fundaliotis A, Parrella LS, Parisi L, Guida B, Chiariello M. Myocardial fibrosis and diastolic dysfunction in patients on chronic haemodialysis. Nephrol Dial Transplant. 2010;25(6):1950-4. http://dx.doi.org10.1093/ndt/gfp747
21. Sarnak MJ, Coronado BE, Greene T, et al. Cardiovascular disease risk factors in chronic renal insufficiency. Clin Nephrol. 2002;57:327-35.
22. [Kutyrina I, Rudenko T, Shvetsov MIu, Kushnir VV. Risk factors of vascular complications in patients at a predialysis stage of chronic renal failure. Terapevticheskij arkhiv. 2006;78(5):45-50 (In Russ.)].
23. Dervisoglu E, Kozdag G, Etiler N, Kalender B. Association of glomerular filtration rate and inflammation with left ventricular hypertrophy in chronic kidney disease patients. Hippokratia. 2012;16(2):137-42. PMID: 23935269. PMCID: PMC3738415
24. Steptoe A, Kivimäki M, Lowe G, Rumley A, Hamer M. Blood Pressure and Fibrinogen Responses to Mental Stress as Predictors of Incident Hypertension over an 8-Year Period. Ann Behav Med. 2016;50:898-906. https://doi.org/10.1007/s12160-016-9817-5
25. Catena C, Colussi G, Fedrizzi S, Sechi LA. Association of a prothrombotic state with left-ventricular diastolic dysfunction in hypertension: a tissue-Doppler imaging study. J Hypertens. 2013;31(10):2077-84. https://doi.org/10.1097/HJH.0b013e328362d951
26. Fassett R, Venuthurupalli SK, Gobe GG, Coombes JS, Cooper MA, Hoy WE. Biomarkers in chronic kidney disease: a review. Kidney Int. 2011;80(8):806-21. http://dx.doi.org/10.1038/ki.2011.198
27. Weiner DE, Tighiouart H, Elsayed EF, Griffith JL, Salem DN, Levey AS, Sarnak MJ. The relationship between nontraditional risk factors and outcomes in individuals with stage 3 to 4 CKD. Am J Kidney Dis. 2008;51(2):212-23. http://dx.doi.org/ 10.1053/j.ajkd.2007.10.035
28. Agarwal S, Thohan V, Shlipak MG, Lima J, Bluemke D, Siscovick D, Gomes A, Herrington D. Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of Atherosclerosis. Intern J Nephrology. 2011:1-7. https://doi.org/ 10.4061/2011/153868
29. Patel P, Ayers CR, Murphy S, Peshock R, Khera A, de Lemos JA, Balko JA, Gupta S, Mammen PPA, Drazner MH, Markham DW.Association of Cystatin C With Left Ventricular Structure and Function: The Dallas Heart Study. Circulation: Heart Fail. 2009;2:98-104. https://doi.org/10.1161/circheartfailure.108.807271
30. Sakuragi S, Ichikawa K, Yamada K, Tanimoto M, Miki T, Otsuka H, Yamamoto K, Kawamoto K, Katayama Y, Tanakaya M, Ito H. Serum cystatin C level is associated with left atrial enlargement, left ventricular hypertrophy and impaired left ventricular relaxation in patients with stage 2 or 3 chronic kidney disease. Int J Cardiol. 2015;190:287-92. https://doi.org/10.1016/j.ijcard.2015.04.189
31. Brady TM, Townsend K, Schneider MF, Cox C, Kimball T, Madueme P, Warady B, Furth S, Mitsnefes M. Cystatin C and Cardiac Measures in Children and Adolescents With CKD. Am J Kidney Dis. 2017;6(2):247-56. https://doi.org/10.1053/j.ajkd.2016.08.036
32. Djoussé L, Kurth T, Gaziano MJ. Cystatin C and Risk of Heart Failure in the Physicians’ Health Study. Am Heart J. 2008;155(1):82-6. https://doi.org/ 10.1016/j.ahj.2007.08.023
33. Taglieri1 N, Koenig W, Kaski1 JC. Cystatin C and Cardiovascular Risk. Clinical Chemistry. 2009;55(11):1932-43. https://doi.org/10.1373/ clinchem.2009.128397
34. Shlipak MG, Katz R, Cushman M, Sarnak MJ, Stehman-Breen C, Psaty BM, Siscovick D, Tracy RP, Newman A, Fried L. Cystatin-C and inflammatory markers in the ambulatory elderly. Am J Med. 2005;118:1416.e25-1416.e31. https://doi.org/10.1016/j.amjmed.2005. 07.060
35. Singh D, Whooley MA, Ix JH, Ali S, Shlipak MG. Association of cystatin C and estimated GFR with inflammatory biomarkers: Heart and Soul Study. Nephrol Dial Transplant. 2007;22:1087-92. https://doi.org/ 10.1093/ndt/gfl744.
36. Xie L, Terrand J, Xu B, Tsaprailis G, Boyer J, Chen QM. Cystatin C increases in cardiac injury: a role in extracellular matrix protein modulation. Cardiovasc Res. 2010;87:628-35. https://doi.org/ 10.1093/cvr/ cvq138
37. [Kozlovskaya LV, Bobkova IN, Varshavskij VA, Proskurneva EP, Miroshnichenko NG, CHebotareva NV, Muhin NA. Fibronektin mochi kak pokazatel' processov fibrozirovaniya v pochke pri nefrite. Terapevticheskij arhiv. 1997;6:34-8 (In Russ.)].
2. Ronco C, Chionh CY, Haapio M, Anavekar NS, House A, Bellomo R. The cardiorenal syndrome. Blood Purif. 2009;27(1):114-26. https://doi.org/ 10.1159/000167018
3. Schiffrin EL, Lipman M, Mann JFE. Chronic kidney disease. Effects on the cardiorenal system. Circulation. 2007;116(1):85-97. https://doi.org/10.1161/ CIRCULATIONAHA.106.678342
4. Longhini C, Molino C, Fabbian F. Cardiorenal syndrome: still not a defined entity. Clinical and Experimental Nephrology. 2010;14(1):12-21.https://doi.org/10.1007/s10157-009-0257-4
5. Мареев В.Ю., Фомин И.В., Агеев Ф.Т., Арутюнов Г.П., Беграмбекова Ю.Л., Беленков Ю.Н., Васюк Ю.А., Галявич А.С., Гарганеева А.А., Гендлин Г.Е., Гиляревский С.Р., Глезер М.Г., Драпкина О.М., Дупляков Д.В., Кобалава Ж.Д., Козиолова Н.А., Лопатин Ю.М., Мареев Ю.В., Моисеев В.С., Недошивин А.О., Перепеч Н.Б., Ситникова М.Ю., Скибицкий В.В., Тарловская Е.И., Чесникова А.И., Шляхто Е.В. Клинические рекомендации. Хроническая сердечная недостаточность (ХСН). Сердечная Недостаточность. 2017;18(1):3-40 [Mareev VYu, Fomin IV, Ageev FT, Arutyunov GP, Begrambekova YuL, Belenkov YuN, Vasyuk YuA, Galyavich AS., Garganeeva AA, Gendlin GE, Gilyarevsky SR, Glezer M G, Drapkina OM, Duplyakov DV, Kobalava Zh D, Koziolova NA, Lopatin YuM, Mareev YuV, Moiseev VS, Nedoshivin AO, Perepech N.B, Sitnikova MYu, Skibitsky VV, Tarlovskaya EI, Chesnikova AI, Shlyakhto EV. Clinical guidelines. Chronic heart failure (CHF). Serdechnaya Nedostatochnost'. 2017;18(1):3-40 (In Russ.)]. https://doi.org/10.18087 /rhfj.2017.1.2346
6. Harnett JD, Foley RN, Kent GM, Barre E, Murray D, Parfrey P. Congestive heart failure in dialysis patients: prevalence, incidence, prognosis, and risk factors. Kidney Int. 1995;47:884-90. https://doi.org/ 10.1038/ki.1995.132
7. Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A, Gong Y, Liu PP. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med. 2006;355:260-69. https://doi.org/10.1056/ NEJMoa051530
8. Herget-Rosenthal S, Bökenkam A, Hofmann W. How to estimate GFR–serum creatinine, serum cystatin C or equations? Clin Biochem. 2007;40(3-4):153-61. https://doi.org/10.1016/j.clinbiochem.2006. 10.014
9. Каюков И.Г., Смирнов А.В., Эмануэль В.Л. Цистатин С в современной медицине. Нефрология. 2012;16(1):22-39 [Kayukov IG, Smirnov AV, Emanuel VL. Cystatin C in current medicine. Nefrologiya. 2012;16(1):22-39 (In Russ.)].
10. Moran A, Katz R, Smith NL, Fried L, Sarnak M, Seliger S, Psaty B, Siscovick D, Gottdiener J, Shlipak M. Cystatin C concentration as a predictor of systolic and diastolic heart failure. J Card Fail. 2008;14:19-26. https://doi.org/10.1016/j.cardfail.2007.09.002
11. Ix JH, Shlipak MG, Chertow GM, Ali S, Schiller N, Whooley M. Cystatin C, Left Ventricular Hypertrophy, and Diastolic Dysfunction: Data From the Heart and Soul Study. J Card Fail. 2006;12(8):601-07. https://doi.org/10.1016/j.cardfail.2006.07.005
12. Швецов М.Ю. Хроническая болезнь почек как общемедицинская проблема: современные принципы нефропрофилактики и нефропротекции. Consilium Medicum. 2014;17(7):51-64 [Shvetsov MY. Khronicheskaya bolezn' pochek kak obshhemeditsinskaya problema: sovremennye printsipy nefroprofilaktiki i nefroprotektsii. Consilium Medicum. 2014;17(7):51-64 (In Russ.)].
13. Stevens P, Levin A. Evaluation and Management of Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2012 Clinical Practice Guideline. Ann Intern Med. 2013;158(11):825-31. https://doi.org/1010.7326/0003-4819-158-11-201306040-00007
14. Sidmal PS, Mallikarjun HP, Shekarappa KC. Pattern and severity of left ventricular diastolic dysfunction in early and end stage renal disease patients with or without dialysis in rural population in South India. International J Biomed Res. 2015;6(08):546-53. https://doi.org/ 10.7439/ijbr
15. Farshid A, Pathak R, Shadbolt B, Arnolda L, Talaulikar G. Diastolic function is a strong predictor of mortality in patients with chronic kidney disease. BMC Nephrology. 2013;14:280. http://dx.doi.org/10. 1186/1471-2369-14-280
16. Шутов А.М., Куликова Е.С., Ивашкина Т.Н., Кондратьева Н.И. Анемия и диастолическая функция левого желудочка у больных с додиализной хронической почечной недостаточностью. Нефрология и диализ. 2001;3(4):422-26 [Shutov AM, Kulikova ES, Ivashkina NI, Kondtatyeva NI. Nephrology and Dialysis. 2001;3(4):422-26 (In Russ.)].
17. Park M, Hsu C-y, Li Y, Mishra RK, Keane M, Rosas SE, Dries D,
Xie D, Chen J, He J, Anderson A, Go A, Shlipak MG. Associations between kidney function and subclinical cardiac abnormalities in CKD. J Am Soc Nephrol. 2012;23:1725-34. http://dx.doi.org/10.1681/ ASN. 2012020145
18. Elloual F, Berkch F, Bayahia R, Benamar L, Cherti M. Comparison of the Effects of Dialysis Methods (Haemodialysis vs Peritoneal Dialysis) on Diastolic Left Ventricular Function Dialysis Methods and Diastolic Function. Open Cardiovasc Med J. 2016;10:171-78. http://dx.doi.org/ 10.2174/1874192401610010171
19. Hayashi SY, Rohani M, Lindholm B, Brodin L-A, Lind B, Barany P, Alvestrand F, Seeberger A. Left ventricular function in patients with chronic kidney disease evaluated by colour tissue Doppler velocity imaging. Nephrol Dial Transplant. 2006;21:125-32. http://dx.doi.org 10.1093/ndt/gfi075
20. Losi MA, Memoli B, Contaldi C, Barbati G, del Prete M, Betocchi S, Cavallaro M, Carpinella G, Fundaliotis A, Parrella LS, Parisi L, Guida B, Chiariello M. Myocardial fibrosis and diastolic dysfunction in patients on chronic haemodialysis. Nephrol Dial Transplant. 2010;25(6):1950-4. http://dx.doi.org10.1093/ndt/gfp747
21. Sarnak MJ, Coronado BE, Greene T, et al. Cardiovascular disease risk factors in chronic renal insufficiency. Clin Nephrol. 2002;57:327-35.
22. Кутырина И.М., Руденко Т.Е., Швецов М.Ю., Кушнир В.В. Факторы риска сердечно-сосудистых осложнений у больных на додиализной стадии хронической почечной недостаточности. Терапевтический архив. 2006;5:45-50 [Kutyrina I, Rudenko T, Shvetsov MIu, Kushnir VV. Risk factors of vascular complications in patients at a predialysis stage of chronic renal failure. Terapevticheskij arkhiv. 2006;78(5):45-50 (In Russ.)].
23. Dervisoglu E, Kozdag G, Etiler N, Kalender B. Association of glomerular filtration rate and inflammation with left ventricular hypertrophy in chronic kidney disease patients. Hippokratia. 2012;16(2):137-42. PMID: 23935269. PMCID: PMC3738415
24. Steptoe A, Kivimäki M, Lowe G, Rumley A, Hamer M. Blood Pressure and Fibrinogen Responses to Mental Stress as Predictors of Incident Hypertension over an 8-Year Period. Ann Behav Med. 2016;50:898-906. https://doi.org/10.1007/s12160-016-9817-5
25. Catena C, Colussi G, Fedrizzi S, Sechi LA. Association of a prothrombotic state with left-ventricular diastolic dysfunction in hypertension: a tissue-Doppler imaging study. J Hypertens. 2013;31(10):2077-84. https://doi.org/10.1097/HJH.0b013e328362d951
26. Fassett R, Venuthurupalli SK, Gobe GG, Coombes JS, Cooper MA, Hoy WE. Biomarkers in chronic kidney disease: a review. Kidney Int. 2011;80(8):806-21. http://dx.doi.org/10.1038/ki.2011.198
27. Weiner DE, Tighiouart H, Elsayed EF, Griffith JL, Salem DN, Levey AS, Sarnak MJ. The relationship between nontraditional risk factors and outcomes in individuals with stage 3 to 4 CKD. Am J Kidney Dis. 2008;51(2):212-23. http://dx.doi.org/ 10.1053/j.ajkd.2007.10.035
28. Agarwal S, Thohan V, Shlipak MG, Lima J, Bluemke D, Siscovick D, Gomes A, Herrington D. Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of Atherosclerosis. Intern J Nephrology. 2011:1-7. https://doi.org/ 10.4061/2011/153868
29. Patel P, Ayers CR, Murphy S, Peshock R, Khera A, de Lemos JA, Balko JA, Gupta S, Mammen PPA, Drazner MH, Markham DW.Association of Cystatin C With Left Ventricular Structure and Function: The Dallas Heart Study. Circulation: Heart Fail. 2009;2:98-104. https://doi.org/10.1161/circheartfailure.108.807271
30. Sakuragi S, Ichikawa K, Yamada K, Tanimoto M, Miki T, Otsuka H, Yamamoto K, Kawamoto K, Katayama Y, Tanakaya M, Ito H. Serum cystatin C level is associated with left atrial enlargement, left ventricular hypertrophy and impaired left ventricular relaxation in patients with stage 2 or 3 chronic kidney disease. Int J Cardiol. 2015;190:287-92. https://doi.org/10.1016/j.ijcard.2015.04.189
31. Brady TM, Townsend K, Schneider MF, Cox C, Kimball T, Madueme P, Warady B, Furth S, Mitsnefes M. Cystatin C and Cardiac Measures in Children and Adolescents With CKD. Am J Kidney Dis. 2017;6(2):247-56. https://doi.org/10.1053/j.ajkd.2016.08.036
32. Djoussé L, Kurth T, Gaziano MJ. Cystatin C and Risk of Heart Failure in the Physicians’ Health Study. Am Heart J. 2008;155(1):82-6. https://doi.org/ 10.1016/j.ahj.2007.08.023
33. Taglieri1 N, Koenig W, Kaski1 JC. Cystatin C and Cardiovascular Risk. Clinical Chemistry. 2009;55(11):1932-43. https://doi.org/10.1373/ clinchem.2009.128397
34. Shlipak MG, Katz R, Cushman M, Sarnak MJ, Stehman-Breen C, Psaty BM, Siscovick D, Tracy RP, Newman A, Fried L. Cystatin-C and inflammatory markers in the ambulatory elderly. Am J Med. 2005;118:1416.e25-1416.e31. https://doi.org/10.1016/j.amjmed.2005. 07.060
35. Singh D, Whooley MA, Ix JH, Ali S, Shlipak MG. Association of cystatin C and estimated GFR with inflammatory biomarkers: Heart and Soul Study. Nephrol Dial Transplant. 2007;22:1087-92. https://doi.org/ 10.1093/ndt/gfl744.
36. Xie L, Terrand J, Xu B, Tsaprailis G, Boyer J, Chen QM. Cystatin C increases in cardiac injury: a role in extracellular matrix protein modulation. Cardiovasc Res. 2010;87:628-35. https://doi.org/ 10.1093/cvr/ cvq138
37. Козловская Л.В., Бобкова И.Н., Варшавский В.А., Проскурнева Е.П., Мирошниченко Н.Г., Чеботарева Н.В., Мухин Н.А. Фибронектин мочи как показатель процессов фиброзирования в почке при нефрите. Терапевтический архив. 1997;6:34-8 [Kozlovskaya LV, Bobkova IN, Varshavskij VA, Proskurneva EP, Miroshnichenko NG, CHebotareva NV, Muhin NA. Fibronektin mochi kak pokazatel' processov fibrozirovaniya v pochke pri nefrite. Terapevticheskij arhiv. 1997;6:34-8 (In Russ.)].
________________________________________________
2. Ronco C, Chionh CY, Haapio M, Anavekar NS, House A, Bellomo R. The cardiorenal syndrome. Blood Purif. 2009;27(1):114-26. https://doi.org/ 10.1159/000167018
3. Schiffrin EL, Lipman M, Mann JFE. Chronic kidney disease. Effects on the cardiorenal system. Circulation. 2007;116(1):85-97. https://doi.org/10.1161/ CIRCULATIONAHA.106.678342
4. Longhini C, Molino C, Fabbian F. Cardiorenal syndrome: still not a defined entity. Clinical and Experimental Nephrology. 2010;14(1):12-21.https://doi.org/10.1007/s10157-009-0257-4
5. [Mareev VYu, Fomin IV, Ageev FT, Arutyunov GP, Begrambekova YuL, Belenkov YuN, Vasyuk YuA, Galyavich AS., Garganeeva AA, Gendlin GE, Gilyarevsky SR, Glezer M G, Drapkina OM, Duplyakov DV, Kobalava Zh D, Koziolova NA, Lopatin YuM, Mareev YuV, Moiseev VS, Nedoshivin AO, Perepech N.B, Sitnikova MYu, Skibitsky VV, Tarlovskaya EI, Chesnikova AI, Shlyakhto EV. Clinical guidelines. Chronic heart failure (CHF). Serdechnaya Nedostatochnost'. 2017;18(1):3-40 (In Russ.)]. https://doi.org/10.18087 /rhfj.2017.1.2346
6. Harnett JD, Foley RN, Kent GM, Barre E, Murray D, Parfrey P. Congestive heart failure in dialysis patients: prevalence, incidence, prognosis, and risk factors. Kidney Int. 1995;47:884-90. https://doi.org/ 10.1038/ki.1995.132
7. Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A, Gong Y, Liu PP. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med. 2006;355:260-69. https://doi.org/10.1056/ NEJMoa051530
8. Herget-Rosenthal S, Bökenkam A, Hofmann W. How to estimate GFR–serum creatinine, serum cystatin C or equations? Clin Biochem. 2007;40(3-4):153-61. https://doi.org/10.1016/j.clinbiochem.2006. 10.014
9. [Kayukov IG, Smirnov AV, Emanuel VL. Cystatin C in current medicine. Nefrologiya. 2012;16(1):22-39 (In Russ.)].
10. Moran A, Katz R, Smith NL, Fried L, Sarnak M, Seliger S, Psaty B, Siscovick D, Gottdiener J, Shlipak M. Cystatin C concentration as a predictor of systolic and diastolic heart failure. J Card Fail. 2008;14:19-26. https://doi.org/10.1016/j.cardfail.2007.09.002
11. Ix JH, Shlipak MG, Chertow GM, Ali S, Schiller N, Whooley M. Cystatin C, Left Ventricular Hypertrophy, and Diastolic Dysfunction: Data From the Heart and Soul Study. J Card Fail. 2006;12(8):601-07. https://doi.org/10.1016/j.cardfail.2006.07.005
12. [Shvetsov MY. Khronicheskaya bolezn' pochek kak obshhemeditsinskaya problema: sovremennye printsipy nefroprofilaktiki i nefroprotektsii. Consilium Medicum. 2014;17(7):51-64 (In Russ.)].
13. Stevens P, Levin A. Evaluation and Management of Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2012 Clinical Practice Guideline. Ann Intern Med. 2013;158(11):825-31. https://doi.org/1010.7326/0003-4819-158-11-201306040-00007
14. Sidmal PS, Mallikarjun HP, Shekarappa KC. Pattern and severity of left ventricular diastolic dysfunction in early and end stage renal disease patients with or without dialysis in rural population in South India. International J Biomed Res. 2015;6(08):546-53. https://doi.org/ 10.7439/ijbr
15. Farshid A, Pathak R, Shadbolt B, Arnolda L, Talaulikar G. Diastolic function is a strong predictor of mortality in patients with chronic kidney disease. BMC Nephrology. 2013;14:280. http://dx.doi.org/10. 1186/1471-2369-14-280
16. [Shutov AM, Kulikova ES, Ivashkina NI, Kondtatyeva NI. Nephrology and Dialysis. 2001;3(4):422-26 (In Russ.)].
17. Park M, Hsu C-y, Li Y, Mishra RK, Keane M, Rosas SE, Dries D,
Xie D, Chen J, He J, Anderson A, Go A, Shlipak MG. Associations between kidney function and subclinical cardiac abnormalities in CKD. J Am Soc Nephrol. 2012;23:1725-34. http://dx.doi.org/10.1681/ ASN. 2012020145
18. Elloual F, Berkch F, Bayahia R, Benamar L, Cherti M. Comparison of the Effects of Dialysis Methods (Haemodialysis vs Peritoneal Dialysis) on Diastolic Left Ventricular Function Dialysis Methods and Diastolic Function. Open Cardiovasc Med J. 2016;10:171-78. http://dx.doi.org/ 10.2174/1874192401610010171
19. Hayashi SY, Rohani M, Lindholm B, Brodin L-A, Lind B, Barany P, Alvestrand F, Seeberger A. Left ventricular function in patients with chronic kidney disease evaluated by colour tissue Doppler velocity imaging. Nephrol Dial Transplant. 2006;21:125-32. http://dx.doi.org 10.1093/ndt/gfi075
20. Losi MA, Memoli B, Contaldi C, Barbati G, del Prete M, Betocchi S, Cavallaro M, Carpinella G, Fundaliotis A, Parrella LS, Parisi L, Guida B, Chiariello M. Myocardial fibrosis and diastolic dysfunction in patients on chronic haemodialysis. Nephrol Dial Transplant. 2010;25(6):1950-4. http://dx.doi.org10.1093/ndt/gfp747
21. Sarnak MJ, Coronado BE, Greene T, et al. Cardiovascular disease risk factors in chronic renal insufficiency. Clin Nephrol. 2002;57:327-35.
22. [Kutyrina I, Rudenko T, Shvetsov MIu, Kushnir VV. Risk factors of vascular complications in patients at a predialysis stage of chronic renal failure. Terapevticheskij arkhiv. 2006;78(5):45-50 (In Russ.)].
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Авторы
Т.Е. РУДЕНКО 1, Е.С. КАМЫШОВА 1, М.П. ВАСИЛЬЕВА 1, И.Н. БОБКОВА 1, Н.И. СОЛОМАХИНА 1, М.Ю. ШВЕЦОВ 1,2
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет), кафедра внутренних, профессиональных болезней и пульмонологии медико-профилактического факультета, клиника нефрологии, внутренних и профессиональных болезней им. Е.М. Тареева Университетской клинической больницы №3, кафедра госпитальной терапии №1 лечебного факультета, Москва, Россия;
2 ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова», факультет фундаментальной медицины, Москва, Россия
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет), кафедра внутренних, профессиональных болезней и пульмонологии медико-профилактического факультета, клиника нефрологии, внутренних и профессиональных болезней им. Е.М. Тареева Университетской клинической больницы №3, кафедра госпитальной терапии №1 лечебного факультета, Москва, Россия;
2 ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова», факультет фундаментальной медицины, Москва, Россия
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