Dzgoeva F U, Gatagonova T M, Kadzaeva Z K, Khamitsaeva O V, Kochisova Z Kh, Dzueva A T, Bazaeva B G, Bestaeva T L
Ter Arkh. 2013;85(6):44-50.
To study the specific features of diastolic dysfunction (DD) in different types of left ventricular (LV) hypertrophy (LVH) in patients with end-stage renal failure (ESRF) and to estimate the cardioprotective effect of erythropoietin.
107 patients (57 women and 50 men) aged 22 to 63 years with ESRF were examined. The follow-up was 18 months. LV ejection fraction, peak early diastolic filling rate, peak late diastolic filling rate, their ratio, LV isovolumic relaxation time, LV end-diastolic diameter, LV end-diastolic volume, LV end-diastolic diameter index (EDDI), LV posterior wall and ventricular septal thickness, and LV mass index were determined. J. Gottdiener's classification based on the calculation of EDDI and LV relative wall thickness was used to estimate LV geometry. Erythropoietin was given to patients with the baseline level of hemoglobin (Hb) < 110 g/l or hematocrit (Ht) < 33%; and iron (III) hydroxide sucrose complex was used to those with ferritin < 100 microg/l or transferrin saturation < 20%. The target level of blood pressure was 130/80 mm Hg; Hb was less than 110 g/l for women and 120 g/l for men; Ht, > 33%.
The patients with ESRF were found to have different types of DD and LVH, the severity of which correlated with the magnitude of renal anemia and arterial hypertension (AH). Adequate correction of anemia and AH promoted the transition of more to less severe DD and LVH and in a number of cases the recovery of LV structure and function.
ESRF is characterized by different types of DD, which are pathogenetically closely related to different types of LVH. Adequate correction of renal anemia and AH may cause a significant reduction and, in a number of cases, alleviate VLH, and normalize LV systolic and diastolic functional values.
研究终末期肾衰竭（ESRF）患者不同类型左心室（LV）肥厚（LVH）中舒张功能障碍（DD）的具体特征，并评估促红细胞生成素的心脏保护作用。
对107例年龄在22至63岁的ESRF患者（57例女性和50例男性）进行检查。随访时间为18个月。测定左心室射血分数、舒张早期充盈峰值速率、舒张晚期充盈峰值速率、它们的比值、左心室等容舒张时间、左心室舒张末期直径、左心室舒张末期容积、左心室舒张末期直径指数（EDDI）、左心室后壁和室间隔厚度以及左心室质量指数。采用基于EDDI和左心室相对壁厚度计算的J.戈特迪纳分类法来评估左心室几何形状。血红蛋白（Hb）基线水平<110 g/l或血细胞比容（Ht）<33%的患者给予促红细胞生成素；铁蛋白<100 μg/l或转铁蛋白饱和度<20%的患者使用氢氧化铁（III）蔗糖复合物。血压目标水平为130/80 mmHg；女性Hb<110 g/l，男性Hb<120 g/l；Ht>33%。
发现ESRF患者存在不同类型的DD和LVH，其严重程度与肾性贫血和动脉高血压（AH）的程度相关。贫血和AH的充分纠正促使更严重的DD和LVH向较轻的转变，并且在一些情况下左心室结构和功能得以恢复。
ESRF的特征是不同类型的DD，其在发病机制上与不同类型的LVH密切相关。肾性贫血和AH的充分纠正可能导致显著减轻，并且在一些情况下缓解左心室肥厚，并使左心室收缩和舒张功能值正常化。
