MANIFESTATIONS OF HEART INSUFFICIENCY IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION COMPLICATED WITH ACUTE KIDNEY DAMAGE

2021 ◽  
pp. 120-127
Author(s):  
Golikov A.V. ◽  
Reiza V.A. ◽  
Tassybayev B.B. ◽  
Gordienko A.V.
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Kidney Injury ◽  
Chronic Heart Failure ◽  
Absolute Risk ◽  
Kidney Injury ◽  
Left Ventricular ◽  
Winter Period ◽  
Study Group ◽  
Type I

Relevance. Acute kidney injury in myocardial infarction worsens its prognosis, including due to the development of chronic heart failure. Moreover, most of the data was obtained for patients over 60 years old. Aim. To evaluate the features of the heart failure manifestations in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 486 patients. A comparative analysis of the heart failure main manifestations frequency in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, analysis of their impact on the risk of chronic heart failure development in acute kidney injury (ANOVA) was performed. Results. The study group (4.0%) differed from the control (21.8%) in a lower frequency of acrocyanosis (p = 0.03) and liver enlargement (8.0 and 25.7%; respectively; p = 0.046) at the end of the eighth week diseases. The main risk markers of the chronic heart failure development in study group were: winter period of the year (absolute risk: 94.1%; relative - 3.76; p = 0.0003), respiratory infections 2-3 times a year (absolute risk: 81.8%; p = 0.003), left ventricular myocardial mass index1 ≥ 173.3 g/m2 (absolute risk: 100%; p = 0.008) and mean arterial pressure1 ≥ 120 mm Hg (absolute risk: 100%; relative - 1.88; p = 0.01). Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by a higher incidence of chronic heart failure. The listed above values of the different predictors should be used in the formation of the high-risk groups for the chronic heart failure in acute kidney injury development, as well as for prognostic modeling.

CORONARY ARTERIES STATE IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION, COMPLICATED WITH ACUTE KIDNEY INJURY

2021 ◽  
pp. 98-105
Author(s):  
Nosovich D.V. ◽  
Epifanov S.Yu. ◽  
Tassybayev B.B.
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Kidney Injury ◽  
Chronic Heart Failure ◽  
Coronary Arteries ◽  
Absolute Risk ◽  
Kidney Injury ◽  
Study Group ◽  
Type I ◽  
General Group

Relevance. The role of the coronary arteries angiographic changes severity in myocardial infarction complicated by acute kidney injury is assessed in different ways. Aim. To evaluate the features of the coronary arteries state in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 168 patients. A comparative assessment of coronary angiography indicators, also acute kidney injury and heart failure development risk analysis (ANOVA) were performed. Results. There were no differences in the compared groups in angiographic data, localization, depth of the lesion, and the frequency of the complicated course of the disease. The study group were characterized by akinesia in the middle anterior (in the studied% 100; control: 15.6%; p =0.02) and antero-septal (100 and 17.7%; respectively; p=0.04) segments , as well as the frequency of registration of chronic heart failure (72.0 and 43.2%; p=0.005) by the eighth week of myocardial infarction. Bypass surgery (absolute risk: 46.2%; relative - 4.37; p=0.0002) and unstable angina (absolute risk: 19.8%; relative - 2,46; p=0.02) in the medical history, as well as the presence of peripheral angiopathies (absolute risk: 18.9%; relative - 3.21; p=0.0008). Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction were not differ in the number and extent of large coronary artery lesions from the general group. They are characterized by large in area and severity of dysfunction lesions of the anterior middle segments of the left ventricle with a higher frequency of chronic heart failure than in the general group. The anamnestic data listed above associated with coronary arteries is advisable to use in the formation of groups at high risk for the acute kidney injury development formation, as well as prognostic modeling.

QUALITY OF LIFE IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION AND ACUTE KIDNEYS INJURY

2021 ◽  
pp. 72-78
Author(s):  
Balabanov A.S. ◽  
Tupitcyn V.V. ◽  
Tassybayev B.B.
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Left Ventricular ◽  
Life Assessment ◽  
Study Group ◽  
Type I

Relevance. The quality-of-life assessment in patients with myocardial infarction and acute kidney injury in differs significantly among different researchers. Aim. To evaluate the changes in the quality-of-life indicator associated with heart failure in men under 60 years old with myocardial infarction and acute kidney injury to search for opportunities to improve prevention. Material and methods. The study included men aged 19-60 years old with type I of myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with acute kidney injury - 25 patients; II - control, without it - 167 patients. A comparative analysis of the quality-of-life indicator associated with heart failure (V. Ironosov) was performed in the selected groups in the first 48 hours (I) and at the end of the third week (II) of myocardial infarction. The changes and correlations (C. Spearmen) of quality-of-life indicator with various clinical features were studied. Results. The quality-of-life in patients in the study group did not differ from the control in both phases of the study (1: 58.8 ± 15.8 and 63.7 ± 20.0; 2: 19.1 ± 8.6 and 20.4 ± 13, 5, respectively; p ˂ 0.05) with positive (68%) dynamics in both groups of patients. Significant correlations of the quality-of-life indicator with age, heart rate, blood pressure, lipid metabolism, left ventricular systolic function, total calcium, GRACE index was revealed. Conclusions. The quality of life associated with heart failure indicator dynamics in the study group did not differ from the control group. Tachycardia, arterial hypertension, dyslipidemia, and hypocalcemia were found to be early markers of deterioration in the quality of life. They can be used in the early diagnosis of chronic heart failure for the timely implementation of preventive measures.

PULMONARY CIRCULATION IN YOUNG AND MIDDLE-AGED MEN WITH ACUTE KIDNEY INJURY DURING MYOCARDIAL INFARCTION

2021 ◽  
pp. 103-109
Author(s):  
Gordienko A.V. ◽  
Balabanov A.S. ◽  
Tassybayev B.B.
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Kidney Injury ◽  
Chronic Heart Failure ◽  
Pulmonary Circulation ◽  
Kidney Injury ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Circulation Parameters

Relevance. Hemodynamics changes of the pulmonary circulation in myocardial infarction complicated by acute kidney injury are not well understood. Aim. To evaluate the characteristics of pulmonary circulation in men under 60 years old with acute kidney injury in myocardial infarction to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 486 patients. A comparative analysis of pulmonary circulation parameters in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, analysis of the risks of developing acute kidney damage and chronic heart failure in the selected groups were performed. Results. The study group differed in a lower heart rate (HR1) (66.3±12.2 from the control group (75.8±18.8; p=0.003). It showed a tendency towards lower the mean pulmonary artery pressure (MPAP) and total pulmonary resistance (TPR) at both points of the study. In both groups, there was a similar dynamic of decrease in the MPAP and TPR levels, more pronounced in the control group (MPAPII: -14.3%; MPAPI: -6.1 %; TPRII: -29.9%; TPRI: -21.8%; p<0.0001) and multidirectional - for HR: in the study group, an increase in HR was noted by 0.9% (p<0.0001), and in the control - its decrease by 8.4% (p<0.0001). Risk markers of the acute kidney injury developing were MPAP1˂30.4 mm Hg, HR1˂67 per minute and TPR1˂622.8 dyne•s•cm-5, the presence of chronic heart failure and cardiac asthma among the disease complication. The predictors of chronic heart failure in the study group were MPAP1≥26.9 mm Hg and HR1≥62 min. Conclusions. In case of acute kidney injury, lower levels of pulmonary circulation indicators are noted, their lower dynamics during the observation period, and a greater frequency of observation of chronic heart failure in comparison with the control group. The above listed values of the pulmonary circulation parameters have been assessed as a risk marker of the acute kidney injury and chronic heart failure development.

THE HEART DAMAGE AND ITS STRUCTURAL STATE FEATURES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION, COMPLICATED WITH ACUTE KIDNEY INJURY

2021 ◽  
pp. 36-44
Author(s):  
Gordienko A.V. ◽  
Golikov A.V. ◽  
Tassybayev B.B. ◽  
Reiza V.A.
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Tricuspid Regurgitation ◽  
Interventricular Septum ◽  
Kidney Injury ◽  
Risk Groups ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Acute Kidney Injury Development

Relevance. The role of hemodynamic changes in myocardial infarction complicated by acute kidney injury is interpreted in different ways. Aim. To evaluate the heart chambers and structures peculiarities in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 366 patients. A comparative assessment of the heart chambers and structures parameters in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, also acute kidney injury development risk analysis (ANOVA) were performed. Results. The study group differed from the control group in smaller sizes of the left atrium2 (38.1±6.0 and 42.0±5.4 (mm), respectively; p=0.01), a higher frequency of the middle anterior (100 and 15.6%; p=0.02) and antero-septal (100 and 17.7; p=0.04) segments akinesia and the absence (0 and 81.5%; p=0.04) of tricuspid regurgitation. In the study group, there was a smaller increase in the ventricles size than in the control group (left: 0.6 and 1.7%, respectively; right: 15.3 and 33.6%) and a greater decrease in the atria size, compared in the control group (left: -1.8 and -25.3%; right: -25.3 and -0.1%) (p<0.0001). The risk markers of the acute kidney injury developing were the dimensions of the left atrium1˂34 mm, interventricular septum≥12.0 mm, end systolic1≥4.23 and diastolic1≥5.3 of the left ventricle, right ventricle1˂2.6; of the right atrium1≥4.7 (cm), the mass of the left ventricle1≥328.8 g. Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by lesions of the middle anterior and antero-septal segments, the absence of tricuspid regurgitation, and a smaller left atrium in the subacute period of the disease. The above of the heart chambers dimensions values should be used in the high-risk groups for the acute kidney injury development formation, as well as for prognostic modeling.

Abstract 23: Immunosuppression with FTY720 Reverses Cardiac Dysfunction to Prevent Chronic Heart Failure in Mice that Survive Diet-induced Myocardial Infarction

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Fu Sang Luk ◽  
Roy Y Kim ◽  
Kang Li ◽  
Daniel Ching ◽  
Sunil Joshi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiac Dysfunction ◽  
Coronary Atherosclerosis ◽  
Left Ventricular ◽  
Lv Function ◽  
Chow Diet ◽  
Type I ◽  
Gene Repair

We recently reported that immunosuppression with FTY720 improves cardiac function and extends longevity in the HypoE/SR-BI-/- mouse model of diet-induced coronary atherosclerosis and myocardial infarction (MI). In this study we tested whether FTY720 could also reverse cardiac dysfunction in mice that survive MI and subsequently develop chronic heart failure (CHF). HypoE/SR-BI-/- mice were bred to Mx1-Cre mice and offspring were fed a high fat diet (HFD) for 21 days to provoke hyperlipidemia, coronary atherosclerosis and recurrent MIs. HypoE/SR-BI-/-Mx1-Cre mice were subsequently given oral FTY720 in drinking water or not. Hyperlipidemia was permanently reversed by inducible Cre-mediated gene repair of the HypoE allele (also known as the Apoeh/h allele) that rapidly restores normal apoE expression in all tissues and by switching mice to a normal chow diet. In cohorts of mice that survived this period of HFD, left ventricular (LV) function was monitored using serial echocardiography for up to 15 weeks. In untreated mice, LV performance progressively deteriorated. Although FTY720 treatment did not initially prevent a decline of heart function among HypoE/SR-BI-/-Mx1-Cre mice six weeks after Cre-mediated gene repair, it almost completely restored normal LV function in these mice by 15 weeks after cessation of HFD. Reversal of heart failure did not result from reduced atherosclerosis as the burden of both aortic and coronary atherosclerosis increased to similar levels in both groups of mice. Rather, FTY720 caused systemic immunosuppression as assessed by reduced numbers of circulating T and B lymphocytes. In the heart, FTY720 led to reduced expression of MMP-2 along with the expression of genes involved in Type I innate inflammation that we have recently demonstrated as major contributors to heart failure. Our data demonstrate the benefit of immunosuppression with FTY720 post MI to prevent progressive pathological remodeling of the heart, which leads to CHF.

THE SYSTEMIC CIRCULATION IN MEN UNDER 60 YEARS OF OLD WITH MYOCARDIAL INFARCTION AND ACUTE KIDNEY INJURY

2021 ◽  
pp. 7-13
Author(s):  
Gordienko A.V. ◽  
Nosovich D.V. ◽  
Tassybayev B.B.
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Kidney Injury ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Kidney Injury ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Acute Kidney Injury Development

Relevance. Hemodynamics changes in myocardial infarction complicated by acute kidney injury are interpreted in different ways. Aim. To evaluate peripheral hemodynamics changes in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 486 patients. A comparative assessment of circulation indices changes in first 48 hours (1) and the end of third week disease (2), their dynamics, also acute kidney injury development risk analysis (ANOVA) were performed. Results. The study group differed from the control group in lower values of heart rate1 (66.3±12.2 and 75.8±18.8 (bpm), respectively; p=0.003) and higher - arterial pressure, systolic1 (155.6±24.0 and 139.5±28.9 (mm Hg); p=0.006), diastolic1 (98.0 ± 16.0 and 86.6 ± 18.9 (mm Hg); p = 0.002), mean1 (117.2±17.6 and 104.3±21.3 (mm Hg); p=0.001). In the study group compared in the control group, there was a greater decrease in blood pressure (mean: -18.3 and -8.3%, respectively) and total peripheral resistance (-33.5 and -26.3%) (p<0.0001). The risk markers of the acute kidney injury development were the mean arterial pressure1≥106.7, systolic1≥140.0, diastolic1≥90.0 (mm Hg) and heart rate1˂66 bpm. Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by arterial hypertension and bradycardia in the first hours of the disease, as well as more pronounced decline dynamics of blood pressure and total peripheral resistance at the end of its subacute period. The listed above values of the circulation parameters should be used in the high-risk groups for the acute kidney injury development formation, as well as prognostic modeling.

THE STRUCTURAL AND FUNCTIONAL MYOCARDIAL STATE PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION AND CHRONIC INFLAMMATORY PULMONARY DISEASES

2021 ◽  
pp. 40-45
Author(s):  
Nosovich D.V. ◽  
Godina Z.N. ◽  
Trinh Trinh Van Nhan
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Volume Index ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Systolic Volume ◽  
Lv Dysfunction ◽  
End Systolic Volume

Relevance. The development of chronic heart failure in chronic inflammatory pulmonary disease (CIPD) after myocardial infarction (MI) remains insufficiently studied. Aim. To evaluate changes in intracardiac hemodynamic parameters in men under 60 years old with CIPD in the acute and subacute MI periods to clarify their significance in the development of chronic heart failure. Material and methods. The study included men aged 19-60 years old with type I MI. Patients are divided into two age-comparable groups: I - the study group, with CIPD - 166 patients; II - control, without it - 490 patients. A comparative assessment of intracardiac hemodynamic in selected groups was performed in first 48 hours (1) and the end of third MI week (2). Results. There was a left ventricle (LV) large dilatation in the study group, as in the first hours of MI (end-systolic volume index (ESVI1) 43.5±21.5 and 36.6±20.7 (ml/m2); p=0.001 ), and at the end of the third week of MI (ESVI2 35.6±16.9 and 32.2±18.4 (ml/m2); p=0.03). There was a left atrium (LA) dilatation (I (1): 40.3±5.3; I (2): 40.9±5.2 (mm) and II (1): 40.7±5.1; II (2): 40.4±5.2 (mm); p≥0.05), right ventricle (RV) dilatation in the first hours of MI (28.3±6.7 and 25.2±6.7 (mm); p = 0.01). There was a significant decrease in the LV ejection fraction in the study group compared to the control at both measurement points (1: 42.6±13.4 and 47.8±13.3 (%), respectively; p=0.0004; 2: 54.9±11.5 and 57.2±12.6 (%); p=0.04). When assessing the dynamics over the observation period, an expansion of the LP was noted in the study group (by 1.4%), in contrast to its decrease in the control group (by 0.6%; p˂0.0001). Also revealed: negative dynamics of the ratio of the velocity of late and early LV filling in the study group (decrease by 6.0%) in comparison with the control (increase by 5.8%; p˂0.0001). Conclusions. Thus, in CIPD, we observed more pronounced dilatation of the RV and LV, systolic and diastolic LV dysfunction in the acute and subacute MI periods. This confirms the negative value of CIPD for the prognosis of MI.

Hydration for prevention of kidney injury after primary coronary intervention for acute myocardial infarction: a randomised clinical trial

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319716
Author(s):  
Yong Liu ◽  
Ning Tan ◽  
Yong Huo ◽  
Shiqun Chen ◽  
Jin Liu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Kidney Injury ◽  
Acute Heart Failure ◽  
Diastolic Pressure ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Controlled Study ◽  
End Point

ObjectiveTo evaluate the efficacy of aggressive hydration compared with general hydration for contrast-induced acute kidney injury (CI-AKI) prevention among patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI).MethodsThe Aggressive hydraTion in patients with STEMI undergoing pPCI to prevenT Contrast-Induced Acute Kidney Injury study is an open-label, randomised controlled study at 15 teaching hospitals in China. A total of 560 adult patients were randomly assigned (1:1) to receive aggressive hydration or general hydration treatment. Aggressive hydration group received preprocedural loading dose of 125/250 mL normal saline within 30 min, followed by postprocedural hydration performed for 4 hours under left ventricular end-diastolic pressure guidance and additional hydration until 24 hours after pPCI. General hydration group received ≤500 mL 0.9% saline at 1 mL/kg/hour for 6 hours after randomisation. The primary end point is CI-AKI, defined as a >25% or 0.5 mg/dL increased in serum creatinine from baseline during the first 48–72 hours after primary angioplasty. The safety end point is acute heart failure.ResultsFrom July 2014 to May 2018, 469 patients were enrolled in the final analysis. CI-AKI occurred less frequently in aggressive hydration group than in general hydration group (21.8% vs 31.1%; risk ratio (RR) 0.70, 95% CI 0.52 to 0.96). Acute heart failure did not significantly differ between the aggressive hydration group and the general hydration group (8.1% vs 6.4%, RR 1.13, 95% CI 0.66 to 2.44). Several subgroup analysis showed the better effect of aggressive hydration in CI-AKI prevention in male, renal insufficient and non-anterior myocardial infarction participants.ConclusionsComparing with general hydration, the peri-operative aggressive hydration seems to be safe and effective in preventing CI-AKI among patients with STEMI undergoing pPCI.

A translational model of chronic heart failure in rats

2018 ◽  
pp. 136-148
Author(s):  
С.А. Крыжановский ◽  
И.Б. Цорин ◽  
Е.О. Ионова ◽  
В.Н. Столярук ◽  
М.Б. Вититнова ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular ◽  
Compensatory Hypertrophy ◽  
Experimental Myocardial Infarction ◽  
Left Ventricular Ejection ◽  
Translational Model ◽  
Innovative Drug ◽  
Ventricular Ejection Fraction

Цель исследования - разработка трансляционной модели хронической сердечной недостаточности (ХСН) у крыс, позволяющей, с одной стороны, изучить тонкие механизмы, лежащие в основе данной патологии, а с другой стороны, выявить новые биомишени для поиска и изучения механизма действия инновационных лекарственных средств. Методика. Использован комплекс эхокардиографических, морфологических, биохимических и молекулярно-биологических исследований, позволяющий оценивать и дифференцировать этапы формирования ХСН. Результаты. Динамические эхокардиографические исследования показали, что ХСН формируется через 90 дней после воспроизведения переднего трансмурального инфаркта миокарда. К этому времени у животных основной группы отмечается статистически значимое по сравнению со 2-ми сут. после воспроизведения экспериментального инфаркта миокарда снижение ФВ левого желудочка сердца (соответственно 55,9 ± 1,4 и 63,9 ± 1,6%, р = 0,0008). Снижение насосной функции сердца (на 13% по сравнению со 2-ми сут. после операции и на ~40% по сравнению с интактными животными) сопровождается увеличением КСР и КДР (соответственно с 2,49 ± 0,08 до 3,91 ± 0,17 мм, р = 0,0002, и с 3,56 ± 0,11 до 5,20 ± 0,19 мм, р = 0,0001), то есть к этому сроку развивается сердечная недостаточность. Результаты эхокардиографических исследований подтверждены данными морфометрии миокарда, продемонстрировавшими дилатацию правого и левого желудочков сердца. Параллельно проведенные гистологические исследования свидетельствуют о наличии патогномоничных для данной патологии изменений миокарда (постинфарктный кардиосклероз, компенсаторная гипертрофия кардиомиоцитов, очаги исчезновения поперечной исчерченности мышечных волокон и т.д.) и признаков венозного застоя в легких и печени. Биохимические исследования выявили значимое увеличение концентрации в плазме крови биохимического маркера ХСН - мозгового натрийуретического пептида. Данные молекулярно-биологических исследований позволяют говорить о наличии гиперактивности ренин-ангиотензин-альдостероновой и симпатоадреналовой систем, играющих ключевую роль в патогенезе ХСН. Заключение. Разработана трансляционная модель ХСН у крыс, воспроизводящая основные клинико-диагностические критерии этого заболевания. Показано наличие корреляции между морфометрическими, гистологическими, биохимическими и молекулярными маркерами прогрессирующей ХСН и эхокардиографическими диагностическими признаками, что позволяет использовать неинвазивный метод эхокардиографии, характеризующий состояние внутрисердечной гемодинамики, в качестве основного критерия оценки наличия/отсутствия данной патологии. Aim. Development of a translational model for chronic heart failure (CHF) in rats to identify new biotargets for finding and studying mechanisms of innovative drug effect in this disease. Methods. A set of echocardiographic, morphological, biochemical, and molecular methods was used to evaluate and differentiate stages of CHF development. Results. Dynamic echocardiographic studies showed that CHF developed in 90 days after anterior transmural myocardial infarction. By that time, left ventricular ejection fraction was significantly decreased in animals of the main group compared with rats studied on day 2 after experimental myocardial infarction (55.9 ± 1.4% vs . 63.9 ± 1.6%, respectively, p<0.0008). The decrease in heart’s pumping function (by 13% compared with day 2 after infarction and by approximately 40% compared to intact animals) was associated with increased ESD and EDD (from 2.49 ± 0.08 to 3.91 ± 0.17 mm, p = 0.0002, and from 3.56 ± 0.11 to 5.20 ± 0.19 mm, respectively, p = 0.0001); therefore, heart failure developed by that time. The results of echocardiographic studies were confirmed by myocardial morphometry, which demonstrated dilatation of both right and left ventricles. Paralleled histological studies indicated presence of the changes pathognomonic for this myocardial pathology (postinfarction cardiosclerosis, compensatory hypertrophy of cardiomyocytes, foci of disappeared transverse striation of muscle fibers, etc.) and signs of venous congestion in lungs and liver. Biochemical studies demonstrated a significant increase in plasma concentration of brain natriuretic peptide, a biochemical marker of CHF. Results of molecular studies suggested hyperactivity of the renin-angiotensin-aldosterone and sympathoadrenal systems, which play a key role in the pathogenesis of CHF. Conclusions. A translational model of CHF in rats was developed, which reproduced major clinical and diagnostic criteria for this disease. Morphometric, histological, biochemical, and molecular markers for progressive CHF were correlated with echocardiographic diagnostic signs, which allows using this echocardiographic, noninvasive method characterizing the intracardiac hemodynamics as a major criterion for the presence / absence of this pathology.

scholarly journals Contrast Volume/Raw eGFR Ratio for Predicting Contrast-Induced Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention for Myocardial Infarction

2015 ◽  
Vol 5 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Hoon Suk Park ◽  
Chan Joon Kim ◽  
Jeong-Eun Yi ◽  
Byung-Hee Hwang ◽  
Tae-Hoon Kim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Roc Curve ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Contrast Volume ◽  
Percutaneous Coronary

Background: Considering that contrast medium is excreted through the whole kidney in a similar manner to drug excretion, the use of raw estimated glomerular filtration rate (eGFR) rather than body surface area (BSA)-normalized eGFR is thought to be more appropriate for evaluating the risk of contrast-induced acute kidney injury (CI-AKI). Methods: This study included 2,189 myocardial infarction patients treated with percutaneous coronary intervention. Logistic regression analysis was performed to identify the independent risk factors. We used receiver-operating characteristic (ROC) curves to compare the ratios of contrast volume (CV) to eGFR with and without BSA normalization in predicting CI-AKI. Results: The area under the curve (AUC) of the ROC curve for the model including all the significant variables such as diabetes mellitus, left ventricular ejection fraction, preprocedural glucose, and the CV/raw modification of diet in renal disease (MDRD) eGFR ratio was 0.768 [95% confidence interval (CI), 0.720-0.816; p < 0.001]. When the CV/raw MDRD eGFR ratio was used as a single risk value, the AUC of the ROC curve was 0.650 (95% CI, 0.590-0.711; p < 0.001). When the CV/MDRD eGFR ratio with BSA normalization ratio was used, the AUC of the ROC curve further decreased to 0.635 (95% CI, 0.574-0.696; p < 0.001). The difference between the two AUCs was significant (p = 0.002). Conclusions: Raw eGFR is a better predictor for CI-AKI than BSA-normalized eGFR.

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