Relationship of Remodeling of Carotid Arteries and Left Ventricular Geometry in Patients With Chronic Glomerulonephritis
https://doi.org/10.18087/cardio.2018.4.10108
Abstract
Purpose: to study clinical-functional features of remodeling of carotid arteries and its relation to restructuring of the left ventricle (LV) in patients with chronic glomerulonephritis at pre-dialysis stage. Materials and methods. We examined 269 patients (189 men, 80 women) with chronic glomerulonephritis (CGN) aged 17-71 years, at pre-dialysis stages of the disease. We analyzed biochemical parameters of peripheral blood with the determination of daily proteinuria and glomerular filtration rate (GFR). For identification of structural changes of carotid arteries (CA) and LV we used Doppler ultrasound and echocardiography. Results. Atherosclerotic changes of CA were found in 79 patients (29.3%). Four patients (1.4%) had history of acute disturbance of cerebral circulation. Concentric type of left ventricular hypertrophy (LVH) was significantly more prevalent among patients with CA remodeling compared with those without (37.84 vs. 18.75%; p=0.006). Eccentric variant of LVH was significantly more prevalent among patients without atherosclerotic lesions in CA compared with those with CA remodeling (81.25% vs. 62.16%; p=0.001). Increased CA intima media thickness positively correlated with body mass index (r=0.273; p=0.014) and negatively - with GFR (r= -0.222; p=0.048). Statistically significant relationships were also found between the presence of carotid atherosclerosis and structural rearrangements of the heart. Conclusion. We demonstrated a clear relationship between GFR, restructuring of CA and concentric type of change of LV geometry, regardless of the presence of traditional risk factors.
About the Authors
Ilchom T. Murkamilov
Кыргызская государственная медицинская академия им. И. К. Ахунбаева; Кыргызско-Российский Славянский университет им. первого Президента России Б. Н. Ельцина
Russian Federation
Russian Federation
K. A. Aitbaev
Национальный центр кардиологии и терапии им. акад. М. Миррахимова при Минздраве КР
Russian Federation
Russian Federation
A. Sh. Sarybaev
Национальный центр кардиологии и терапии им. акад. М. Миррахимова при Минздраве КР
Russian Federation
Russian Federation
V. V. Fomin
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет)
Russian Federation
Russian Federation
I. G. Gordeev
ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России
Russian Federation
Russian Federation
Z. R. Rayimzhanov
ФГБУ «Главный военный клинический госпиталь им. академика Н. Н. Бурденко» Министерства обороны Российской Федерации
Russian Federation
Russian Federation
N. A. Redjapova
Ошский государственный университет
Russian Federation
Russian Federation
F. A. Yusupov
Ошский государственный университет
Russian Federation
Russian Federation
References
1. Mukhin N. A., Moiseev V. S. Cardiorenal ratio and the risk of cardiovascular diseases. Vestnik RAMN 2003;11:50-55. Russian (Мухин Н. А., Моисеев В. С. Кардиоренальные соотношения и риск сердечно-сосудистых заболеваний. Вестник РАМН 2003;11:50-55).
2. Tomilina N. A., Volgina G. V., Bikbov B. T. et al. The problem of cardiovascular disease in chronic renal failure. Nephrology and dialysis 2003;5 (1):15-24. Russian (Томилина Н. А., Волгина Г. В., Бикбов Б. Т. и др. Проблема сердечно-сосудистых заболеваний при хронической почечной недостаточности. Нефрология и диализ 2003;5 (1):15-24).
3. Smirnov A. V., Dobronravov V. A., Kayukov I. G. The Cardiorenal continuum: pathogenetic basis of preventive medicine. Nephrology 2005;3:7-15. Russian (Смирнов А. В., Добронравов В. А., Каюков И. Г. Кардиоренальный континуум: патогенетические основы превентивной нефрологии. Нефрология 2005;3:7-15).
4. Meguid A., Nahas E. I., Bello A. K. et al. Chronic kidney disease: the global challenge. Lancet 2005;365 (9456):331-340. PMID:15664230. DOI:10.1016/S0140-6736 (05) 17789-7.
5. Weiner D. E., Tighcourt H., Amin M. G. et al. Chronic kidney disease as a risk factor for cardiovascular disease and all cause mortality. A pooled analysis of community based studies. J Am Soc Nephrol 2004;15:1307-1315. PMID:15100371.
6. Fornadi K., Zsuzsanna Ronai K., Turanyi C. Z. et al. Sleep apnea is not associated with worse outcomes in kidney transplant recipients. Sci Rep 2014;4: 6987. DOI:10.1038/srep06987.
7. Dutta P. K., Das S. Value of electrocardiogram in predialytic chronic kidney disease patient without known coronary artery disease. Int J Med Res Health Sci 2014;3 (4):967-974. DOI:10.5958/2319-5886.2014.00033.2.
8. Tonelli M., Wiebe N., Culleton B. et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol 2006; 17 (7):2034-2047. PMID:16738019. DOI: 10.1681/ASN. 2005101085.
9. Foley R. N., Levin A. Cardiovascular Disease in Chronic Renal Insufficiency. Am J Kidney Dis 2000; 36:24-30. PMID:11118155.
10. Bregman R., Lemos C., Filho R. P. et al. Left ventricular hypertrophy in patients with chronic kidney disease under conservative treatment. J Bras Nefrol 2010;32 (1):83-88. D0I.org/10.1590/S0101-28002010000100014.
11. Shoji T., Emoto M., Tabata T. et al. Advanced atherosclerosis in predialysis patients with chronic renal failure. Kidney Int 2002;61:2187-2192. PMID: 12028459. DOI:10.1046/j. 15231755.2002.00372. x.
12. Lu B., Wan J., Yang Y. et al. The estimated glomerular filtration rate is associated with subclinical atherosclerosis, independently of albuminuria, in patients with type 2 diabetes. Int Angiol 2013;32 (5):532-539. PMID:23903314.
13. Zoccali C., Benedetto F. A., Mallamaci F. et al. Left ventricular mass monitoring in the follow-up of dialysis patients: prognostic value of left ventricular hypertrophy progression. Kidney Int 2004;65:1492-1498. PMID:15086493 DOI: 10.1111/j. 15231755.2004.00530.
14. Kalantar-Zadeh K., Block G., Humphreys M. H. et al. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int 2003;63:793-808. PMID:12631061. DOI:10.1046/j. 1523-1755.2003.00803. x.
15. Drechsler D., Kornacewicz Janh Z. Assessment of carotid arteries and Pulse Wave Velocity in patients with three vessel coronary disease. Kardiologia Polska 2002; (57):193-197.
16. Devereux R. B., Alonso D. R., Lutas E. M. et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am Heart J 1986;57:450-458. PMID:2936235.
17. Mancia G., Fagard R., Narkiewicz K. et al. ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertension 2013;31 (7):1281-1357.
18. Di Lullo L., Gorini A., Russo D. et al. Left Ventricular Hypertrophy in Chronic Kidney Disease Patients: From Pathophysiology to Treatment. Cardiorenal Med 2015;5:254-266. DOI: 10.1159/000435838.
19. Young T., Skatrud J., Peppard P. E. Risk factors for obstructive sleep apnea in adults. JAMA 2004;291:2013-2016. PubMed: 15113821. DOI:10.1001 /jama. 291.16.2013.
20. Collins A.J., Li S., Gilbertson D.J. et al. Chronic kidney disease and cardiovascular disease in the medicare population. Kidney Int 2003;87:24-31. PMID:14531770.
21. Chhajed N., Chandra B. S., Shetty M. S., & Shetty C. Correlation of carotid intimal-medial thickness with estimated glomerular filtration rate and cardiovascular risk factors in chronic kidney disease. Saudi Journal of Kidney Diseases and Transplantation 2014;25 (3): 572. DOI: 10.4103/1319-2442.132186.
22. Lambrinoudaki I., Tourlakis D., Armeni E. et al. Variations in glomerular filtration rate are associated with subclinical atherosclerosis in healthy postmenopausal women. Menopause 2015;22 (3):317-324. DOI: 10.1097/GME. 0000000000000302.
23. Gentile M., Panico S., Mattiello A. et al. Plasma creatinine levels, estimated glomerular filtration rate and carotid intima media thickness in middle-aged women: a population based cohort study. Nutr Metab Cardiovasc Dis 2014;24 (6):677-680. DOI: 10.1016/j. numecd. 2013.11.012.
24. Campean V., Neureiter D., Varga I. et al. Atherosclerosis and vascular calcification in chronic renal failure. Kidney Blood Press Res 2005;28:280-289. PMID:16534222.DOI:10.1159/000090182.
25. lechnowicz-Tietz S., Gluba A., Paradowska A. et al. The risk of atherosclerosis in patients with chronic kidney disease. Int Urol Nephrol 2013;45:1605-1612. PMID:23483304. D0I 10.1007/s11255-013-0407-1.
26. Glynn L. G., Reddan D., Newell J. et al. Cronic kidney disease and mortality and morbidity among patients with established cardiovascular diseas: a West of Ireland communiti-based cohort study. Nephrol Dial Transplant 2007;22:9:2586-2594. PMID:17452408. DOI:10.1093/ndt/gfm222.
27. Pankina O. V., Tatarintsev P. B., Ragozin 0. N. Influence of uremic factors in the processes of remodeling of peripheral vessels in patients with chronic kidney disease. Modern problems of science and education. 2013;1; URL: http. V/www.science-education. EN/107-8509. Russian (Пьянкина О. В., Татаринцев П. Б., Рагозин О. Н. Влияние уремических факторов на процессы ремоделирования периферических сосудов у больных хронической болезнью почек. Современные проблемы науки и образования 2013; 1 ; URL: http. V/www.science-education. ru/ 107-8509.
28. Middleton R.J., Parfrey P. S., Foley R. N. Left ventricular hypertrophy in the renal patient. J Am Soc Nephrol 2001;12:1079-1084.
29. Yaggi H. K., Concato J., Kernan W. N. et al. 0bstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005;353:2034-2041. PubMed: 16282178.
30. Locatelli F., Marcelli D., Conte F. et al. Cardiovascular disease in chronic renal failure: the challenge continues. Nephrol Dial Transplant 2000;15 [Suppl 5]:69-80. PMID:11073278.
31. Matsushita K., van der Velde M., Astor B. C. et al. Chronic Kidney Disease Prognosis Consortium. Association of estimated glomerular filtration rate and albuminuria with allcause and cardiovascular mortality in general population cohorts: a collaborativemeta-analysis. Lancet 2010;375 (9731):2073-2081.
32. Preston E., Ellis M. R., Kulinskaya E. Association between carotid artery intima-media thickness and cardiovascular risk factors in CKD. Am J Kidney Dis 2005;46:856-862. PMID: 16253725. DOI:10.1053/j. ajkd. 2005.07.048.
33. Hasegawa D., Tanaka A., Inaguma D. et al. Association between Plaque Score of the Carotid Artery and the Severity of Sleep Apnea Syndrome in Patients with Chronic Kidney Disease. Cardiorenal Med 2016;6:159-168. PMID: 26989401. DOI: 10.1159/000443748.
34. Ivannikova E. V., Kalashnikov V. Yu., Smirnova O. M. et al. The effect of fibroblast growth factors and advanced glycation end-products on the intima-media complex thickness in patients with coronary heart disease and type 2 diabetes. Russian (Иванникова Е. В., Калашников В. Ю., Смирнова О. М. и соавт. Влияние факторов роста фибробластов и конечных продуктов гликирования на толщину комплекса интима-медиа у больных с ишемической болезнью сердца и сахарным диабетом 2 типа. Сахарный диабет 2014; (2):47-55). DOI: 10.14341 /DM2014247-55.
35. Bestaeva T., Dzgoeva F., Sopoev M. Role fibroblast growth factor-23 (FGF-23) in developmently of cardiorenal outcomes in chronic kidney disease stages III-V. Vladikavkazskij mediko-biologicheskij vestnik 2015;20:30:36-41. Russian (Бестаева Т. Л., Дзгоева Ф. У., Сопоев М. Ю. Роль фактора роста фибробластов-23 (FGF-23) в развитии кардиоренальных осложнений у больных с III-V стадией хронической болезни почек. Владикавказский медико-биологический вестник 2015;20:30:36-41). DOI: 10.12737/11822. DOI: 10.12737/11822
36. Milovanova L. Yu., Milovanov Yu. S., Kudryavtseva D. V. et al. The role of the morphogenetic proteins FGF-23, Klotho and glycoprotein sclerostin in assessing the risk of developing cardiovascular disease and prognosis of chronic kidney disease. Therapeutic archive 2015;87 (6):10-16. Russian (Милованова Л. Ю., Милованов Ю. С., Кудрявцева Д. В. и др. Роль морфогенетических белков FGF-23, Klotho и гликопротеина склеростина в оценке риска развития сердечно-сосудистых заболеваний и прогноза хронической болезни почек. Терапевтический архив 2015;87 (6):10-16.)
37. Levin A., Thompson C. R., Ethier J. et al. Left ventricular mass index increase in early renal disease: impact of decline in hemoglobin. Am J Kidney Dis 1999;34:125-134. PMID:10401026. DOI:10.1053/AJKD03400125.
38. DeLima J. J., Vieira M. L., Abensur H. et al. Baseline blood pressure and other variables influencing survival on hemodialysis of patients without overt cardiovascular disease. Nephrol Dial Transplant 2001;16:793-797. PMID:11274276.
39. Zoccalli C., Benedetto S. M., Mallamaci F. et al. Prognostic impact of the indexation of left ventricular mass in patients undergoing dialysis. Am. Soc. Nephrol 2001;12:2768-2774. PMID:11729247.
40. London G. M., Pannier B., Guerin A. P. et al. Alterations of left ventricular hypertrophy in and survival of patients receiving hemodialysis: follow-up of an interventional study. J Am Soc Nephrol 2001;12:2759-2767. PMID:11729246.
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For citations:
Murkamilov I.T., Aitbaev K.A., Sarybaev A.Sh., Fomin V.V., Gordeev I.G., Rayimzhanov Z.R., Redjapova N.A., Yusupov F.A. Relationship of Remodeling of Carotid Arteries and Left Ventricular Geometry in Patients With Chronic Glomerulonephritis. Kardiologiia. 2018;58(4):45-52. (In Russ.) https://doi.org/10.18087/cardio.2018.4.10108
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