[Renal dysfunction and anemia in old patients with diastolic cardiac failure].
OBJECTIVE
To study the effects of renal functional insufficiency and anemia on clinical symptoms and diastolic filling of the left ventricle in aged patients with chronic diastolic cardiac failure (CDCF).


METHODS
We examined 116 patients (69 females, 47 males) with CDCF (ejection fraction > 45%) of functional class I-IV aged 65-86 (76.4 +/- 5.2) years. Anemia was diagnosed in men with hemoglobin under 130 g/l, in women--under 120 g/l. Glomerular filtration rate (GFR) was calculated by Cockcroft- Gault formula.


RESULTS
GFR < 60 ml/min/1.73 m2 was observed in 42 (36.2%) patients; anemia--in 33 (28.4%) patients, combination of anemia with subnormal renal function--in 21 (18.1%). Left ventricular hypertrophy was diagnosed in 101 (87.1) patients. Type of transmitral circulation with impaired relaxation, pseudonormal and restrictive was detected in 80 (69%), 29 (25%) and 7 (6%) patients, respectively. There is a direct correlation between hemoglobin content and GFR (r = 0.33; p < 0.01). Functional class of CDCF in anemic patients and anemia combination with subnormal GFR was higher than in patients free of anemia. It was established that the less GFR rate is the longer is the time of isovolumic relaxation of the left ventricle; the lower hemoglobin the greater is the velocity of early diastolic filling.


CONCLUSIONS
In aged patients with CDCF diastolic filling depends not only on age, heart rate, structural changes of the heart but also on reduced renal function, anemia, systolic arterial pressure.
Shutov
A M
AM
Tarmonova
L Iu
LIu
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D054144:Heart Failure, Diastolic / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D051437:Renal Insufficiency / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology
D006454:Hemoglobins