[Scintigraphic evaluation of impairments in cardiopulmonary hemodynamics and renal functional activity in patients with coronary heart disease and circulatory failure].

OBJECTIVE

To evaluate the relationship between impairments in cardiopulmonary hemodynamics and renal functional activity in patients with circulatory failure, by applying radionuclide studies.

MATERIAL AND

METHODS

Sixty-nine patients with coronary heart disease (mean age 53.23 +/- 0.87 years) with the development of NYHA functional classes II-III chronic HF were examined. To calculate cardiopulmonary hemodynamic parameters, all the patients underwent 99mTc pertechnetate radiocardiopulmonography. Their renal functional activity was assessed by dynamic radionuclide renal scintigraphy using 99mTc-DTPA.

RESULTS

The examinees had most abnormal systemic and pulmonary hemodynamic parameters. Renal dysfunction was detected in 74% of the examinees and reflected by decreased glomerular filtration rates in one or both kidneys and/or a longer tracer elimination half-life from the renal parenchyma. Stepwise regression analysis established a strong inverse correlation between impaired pulmonary circulation, on the one hand, and reduced renal filtration, on the other, and a direct correlation of impairments in renal filtration and evacuation with both left and right ventricular contractility.

CONCLUSION

Radionuclide studies are the methods of choice for diagnosis of the cardiorenal continuum.