Chronic heart failure in patients with chronic kidney disease

Aim. The aim of this investigation was to study clinical manifestation of chronic heart failure in patients with chronic kidney disease in pre-dialysis stage and the functional condition of the heart. Methods. Seventy-three pre-dialysis patients (40F, 33M, age 51,7 ± 13,4 years) who have chronic kidney disease and chronic heart failure were studied. M-mode echocardiography was performed and left ventricular mass index (LVMI), ejection fraction (EF) were calculated. Transmitral flow was assessed by Doppler echocardiography. Peak velocity of early (E) and late (A) filling, E/A ratio, isovolumic relaxation time (IVRT) and early deceleration time (DT) were detected. The flow propagation velocity of early diastolic filling (Vp) was assessed by color M-mode Doppler echocardiography. All measures were performed by one investigator. Results. Left ventricular hypertrophy was detected in 58 (79,5%) patients. EF was lower than 45% in 7 patients. 55 (75,4%) patients had diastolic dysfunction. Abnormal relaxation type of diastolic dysfunction was prevalent. In 11 (15,1%) patients after investigation the chronic heart failure was excluded. Conclusion. Diagnostics of chronic heart failure based on its symptoms is difficult in patients with chronic kidney disease. Systolic dysfunction is quite rare in patients with CKD. Diastolic dysfunction of left ventricular is the main cause of CHF in patients with CKD. In this connection, the investigation of transmitral flow by Doppler-echocardiography must be essential in patients with CKD suffering from CHF.

диастолическая дисфункция, допплер-эхокардиография, хроническая болезнь почек, хроническая почечная недостаточность, хроническая сердечная недостаточность

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