Klinicheskaia meditsina · 2009
[Specific features of cardiac insufficiency in elderly patients with chronic renal disease].
Сравнительное исследованиеАннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Serov V A, Shutov A M, Khiteeva S V, Makeeva E R, Serova S I, Troshen'kina O V
Аннотация
AIM OF THE STUDY: To evaluate clinical features of chronic cardiac insufficiency (CCI) in elderly patients with renal dysfunction.
MATERIALS AND METHODS: 260 patents (143 men and 117 women) aged above 60 (mean 68.7 +/- 6.6) yr with I-IV FC CCI. 25 patients had hypertensive disease (HD), 30 coronary heart disease (CHD), 205 HD+CHD. Glomerular filtration rate (GFR) was estimated using MDRD formula.
RESULTS: Chronic renal disease (CRD) with GFR reduced below 60 ml/min/1.73 m2 was diagnosed in 126 (48.5%) patients. Its severity was not significantly different between patients with and without CCI. (2.3 +/- 0.7 and 2.1 +/- 0.7 respectively, p = 0.13). The entire study group was dominated by men, the CCI group by women. Atrial fibrillation (AF) was diagnosed in 25.8% of the patients with CI + CRD. Multivariate regression analysis revealed independent correlation of AF with CCI FC (p = 0.02) and GFR (p = 0.2). CCI patients with CRD had higher frequency of mitral regurgitation (MR) than without CRD. Occurrence of MR correlated with age (p < 0.001) and GFR (p < 0.001).
CONCLUSION: 1. Renal dysfunction occurred in 48.55% of elderly patients with CCI. 2. A distinctive clinical feature of CCI + CRD in elderly patients is frequent development of AF and MR. 3. CCI + CRD is more frequent in women and CCI without CRD in men.
MATERIALS AND METHODS: 260 patents (143 men and 117 women) aged above 60 (mean 68.7 +/- 6.6) yr with I-IV FC CCI. 25 patients had hypertensive disease (HD), 30 coronary heart disease (CHD), 205 HD+CHD. Glomerular filtration rate (GFR) was estimated using MDRD formula.
RESULTS: Chronic renal disease (CRD) with GFR reduced below 60 ml/min/1.73 m2 was diagnosed in 126 (48.5%) patients. Its severity was not significantly different between patients with and without CCI. (2.3 +/- 0.7 and 2.1 +/- 0.7 respectively, p = 0.13). The entire study group was dominated by men, the CCI group by women. Atrial fibrillation (AF) was diagnosed in 25.8% of the patients with CI + CRD. Multivariate regression analysis revealed independent correlation of AF with CCI FC (p = 0.02) and GFR (p = 0.2). CCI patients with CRD had higher frequency of mitral regurgitation (MR) than without CRD. Occurrence of MR correlated with age (p < 0.001) and GFR (p < 0.001).
CONCLUSION: 1. Renal dysfunction occurred in 48.55% of elderly patients with CCI. 2. A distinctive clinical feature of CCI + CRD in elderly patients is frequent development of AF and MR. 3. CCI + CRD is more frequent in women and CCI without CRD in men.