Beishebaeva Nasira
National Center of Cardiology and Therapy, Kyrgyzstan
Title: Clinical evaluation of diastolic dysfunction of the left ventricle depending in different morphologic forms of glomerulopathies
Biography
Biography: Beishebaeva Nasira
Abstract
Purpose: Assess the diastolic dysfunction (DD) of the heart with different forms of glomerulopathies (GP).
Materials and Methods: 55 patients with GP were examined (32 men, 23 women) aged from 17 to 58 years (on the average 32.76±10.3). All patients carried out kidney biopsy. IgA, IgG and IgM GP were diagnosed.
Results: The disease debuted at a young age of over 17 years in most patients (78.1%). Clinically, most often there was a nephrotic syndrome (in 65.4%), and in most cases - in men (72.2%). Systolic and diastolic blood pressure was 130.3±20.0 mm Hg. Art and 83.2±13.06 mm Hg. art., respectively. By the nature of the immune deposits with different morphological types of GP, we divided them into three subgroups. In the course of the analysis, the highest value of blood pressure was found in patients with IgG and IgM deposits (138.3±21.6 mm Hg and 136.0±21.0 mm Hg, respectively), so there is a reason to believe, that the formed immune complexes are a factor of endothelial damage. In the study of clinical data, statistically significant differences between groups of patients were revealed. DD was diagnosed in 36.4% of patients with heart failure in the early stages of the disease, before the development of renal failure. The main differences between cohorts were a significant elongation of the isovolumic relaxation time (IVRT) in the group with IgM nephropathy (P<0.005). However, a significant difference in late diastolic movement of the medial part of the mitral ring [A'] (P<0.04) was observed only in the group of patients with IgM nephropathy.
Conclusion: Left ventricular diastolic dysfunction was diagnosed in each third patient with GP in the onset of the disease, without renal failure. The most pronounced signs of diastolic filling identified in patients with IgM nephropathy, as evidenced by the significant differences between groups.