Clinical and functional features of renal dysfunction in patients with chronic obstructive pulmonary disease and arterial hypertension

Abstract

Clinical and functional features of renal dysfunction are considered in patients suffering from chronic obstructive pulmonary disease and arterial hypertension. It was found that left atrial hypertrophy in patients suffering from chronic obstructive pulmonary disease, without concomitant arterial hypertension, is 13,9%, with concomitant pathology – 9,37%. In the general group of patients, the frequency of the hypertrophic type of diastolic dysfunction of the left ventricle occurs in 26,7% of cases. The revealed tendency to dilate the left atrium may be associated with impaired diastolic function of the left ventricle. In the group of patients with a combination of chronic obstructive pulmonary disease and arterial hypertension, the frequency of remodeling of the right ventricle of the heart is significantly higher compared to the group of patients without arterial hypertension (21,3% versus 14%), which is due to the complex picture of structural changes in the right ventricle due to ventricular septal hypertrophy and its displacement towards the left ventricle. In addition, with a combination of chronic obstructive pulmonary disease and arterial hypertension, the frequency of diastolic ventricular dysfunction is also significantly higher compared to the group of patients without arterial hypertension (51,1% versus 30,2%). At the same time, the frequency of right ventricular hypertrophy is less in comparison with a group of patients suffering from chronic obstructive pulmonary disease in combination with arterial hypertension. We believe that right ventricular myocardial hypertrophy is a very late and even optional stage in the development of chronic pulmonary heart and right ventricular heart failure, since right ventricular dilation occurs in the initial stage of the disease. Levels of cystatin C and microalbuminuria significantly increase as chronic obstructive pulmonary disease progresses. The presence of a correlation between these markers of renal dysfunction and heart remodeling parameters was revealed, which indicates the contribution of the hemodynamic factor to the progression of chronic kidney disease in patients suffering from chronic obstructive pulmonary disease. An increase in the level of cystatin C in chronic obstructive pulmonary disease is consistent with the results of studies by other authors. Moreover, such deviations are associated with the systemic effects of obstructive pulmonary disease.

Keywords

chronic obstructive pulmonary disease / heart remodeling / cystatin C / microalbuminuria / arterial hypertension / markers of renal dysfunction / pulmonary heart / right ventricular heart failure

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RIGHTS & PERMISSIONS

Churilov Y.K., Moiseev Y.B., Richei I.I.