Reduced Coronary Flow Reserve and Early Diastolic Filling Abnormalities in Patients with Nephrotic Syndrome

Autor:	Huseyin Oflaz, Fatma Sen, Sengul Kavak Bayrakli, Halil Yazici, Ali Elitok, Mustafa Tukenmez, Aydin Turkmen, Ebru Golcuk, Erdem Kasikcioglu, Arif Oguzhan Cimen
Rok vydání:	2008
Předmět:	Adult Male medicine.medical_specialty Nephrotic Syndrome Adolescent Diastole Renal function Critical Care and Intensive Care Medicine Ventricular Function Left Young Adult Coronary Circulation Internal medicine medicine Humans Hypoalbuminemia Blood urea nitrogen medicine.diagnostic_test business.industry Microcirculation Coronary flow reserve Stroke Volume Glomerulonephritis General Medicine Middle Aged medicine.disease Cross-Sectional Studies Endocrinology Echocardiography Nephrology Case-Control Studies Erythrocyte sedimentation rate Cardiology Female Endothelium Vascular business Pericardium Nephrotic syndrome
Zdroj:	Renal Failure. 30:914-920
ISSN:	1525-6049 0886-022X
DOI:	10.1080/08860220802353819
Popis:	Increased cardiovascular disease risk is very well known in nephrotic syndrome. Coronary flow reserve measurement by trans-thoracic echocardiography reflects coronary microvascular and endothelial function. However, diastolic filling abnormalities by echocardiography may indicate diastolic dysfunction. Our aim was to evaluate endothelial and diastolic functions by trans-thoracic echocardiography in nephrotic syndrome.Eighteen patients with nephrotic syndrome (five females, 34 +/- 17 years) and 30 controls (10 females, 35 +/- 10 years) were evaluated in this cross-sectional observational study. Age, weight, lipid profile, glucose, blood urea nitrogen, creatinine, serum albumin, total protein, C-reactive protein, erythrocyte sedimentation rate, blood pressures, 24-hour urine volume, and protein were recorded. Glomerular filtration rate was estimated by Cockcroft-Gault Formula. Doppler flow and other echocardiographic parameters were measured by Vivid 7 echocardiography.Coronary flow reserve was significantly lower in patients than controls (p0.001) and was negatively correlated with proteinuria (p0. 001), creatinine levels (p = 0.03), total cholesterol (p = 0.02), C-reactive protein (p = 0.02), and erythrocyte sedimentation rate (p = 0.005). E/A ratio was significantly lower in patients than in controls (p = 0.005). DT was significantly higher in patients than in controls (p = 0.01) and isovolumic relaxation time was similar in both groups.Coronary flow reserve and left ventricular diastolic filling are significantly impaired in nephrotic syndrome. Proteinuria, serum creatinine, total cholesterol and inflammation may have all contributory effects on endothelial dysfunction. Early evaluation of patients with nephrotic syndrome should include coronary flow and diastolic function by echocardiography.
Databáze:	OpenAIRE
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