The role of major vessels remodeling in development of left ventricular hypertrophy in patients with a predialysis stage of chronic renal failure

Aim. To study correlation between development of left ventricular hypertrophy (LVH) and remodeling of major arteries at a predialysis stage of chronic renal failure (CRF). Material and methods. A total of 95 non-diabetic patients (48 males - 51% and 47 females - 49%) with stage II-III CRF entered the trial. A mean age of the patients was 46.7 years (95% CI 43.7-49.8 years). Glomerular filtration rate calculated by Cockrott-Gault formula was 37.7 ml/min (33.9-41.4 ml/min), blood creatinine level - 2.9 mg/dl (2.6-3.2 mg/dl). Arterial hypertension (AH) was registered in 96% patients, smoking - in 40%, cardiovascular hereditary burden - in 54%, hyperilpidemia - in 66%, overweight - in 60%, anemia - in 34%, hyperphosphatemia - in 45%. Echocardiography, ultrasonic dopplerography of the common carotid arteries (CCA) and common femoral artery (CFA) were performed in 83 and 37patients, respectively. Results. LVH (LV myocardium mass index >134 g/m2for males and >110 g/m2 for females) was detected in 37.3% patients. Concentric remodeling was recorded in 31.3%, concentric myocardial hypertrophy - in 19.1% patients, excentric hypertrophy - in 18.1%. Development of LVH was linked with age, high systolic and pulse blood pressure, marked renal dysfunction, anemia, elevated ESR and hyperphosphatemia. The presence of LVH correlated with increased thickness of intima-media complex (IMC) of CCA and CFA (r=0.65, p<0.01 and r=0.51, p<0.05, respectively). There was correlation between thickness of LV posterior wall and impairment of CCA elasticity (r = -0.42, p < 0.05). Conclusion. Patients with initial and moderate disorders of renal function frequently have LVH related to conventional and "renal" risk factors. A LV mass increase and structural-functional changes of major vessels strongly correlate.