Features in the Processes of Left Ventricular Remodeling Depending on the Degree of Renal Dysfunction in Patients with Chronic Heart Failure

Abstract

Background: The aim of this research was to study the features of changes in the parameters of heart remodeling in patients with coronary heart disease (CHD) and chronic heart failure (CHF), depending on the degree of renal dysfunction (RD). Methods and Results: The study included 150 CHD patients with NYHA functional class (FC) I-IIII of CHF. All examined patients were subdivided according to the level of eGFR: Group A included 81 patients with CHF FCI-III and eGFRCKD-EPI>60 mL/min per 1.73m2; Group B included 69 patients with CHF FCI-III and eGFRCKD-EPI≤60 mL/min per 1.73m2. It was found an increase in left ventricular (LV) mass in Group B by 11.4%, compared to Group A (P=0.000). Analysis of LV systolic function showed that in Group B, values of LF ejection fraction and fractional shortening were significantly lower than in Group A (47.64±0.61% vs. 52.7±0.28%, and 25.40±0.46% vs. 28.23±0.25%, respectively, P=0.000). Thus, in Group B, we found CHFrEF, compared to Group A with CHFpEF. Analysis of diastolic function revealed that in Group B, the E/A ratio was statistically higher than in Group A (1.12±0.05 vs. 0.81±0.04, respectively, P=0.000). At the same time, in Group B, values of IVRT and DT were significantly lower than in Group A (85.01±0.8 ms vs. 91.25±0.99 ms, and 177.8±2.1 ms vs. 197.5±2.07 ms, respectively, P=0.000). Thus, the signs of the impaired relaxation (Grade 1 DD) and the pseudonormal filling pattern (Grade 2 DD) were found in Group A and Group B, respectively. Conclusion: RD in patients with CHF is an important factor in the significant deterioration of LV systolic and diastolic functions.