Связь дисфункции почек с состоянием эндотелия у больных с острым инфарктом миокарда с подъемом сегмента ST

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Abstract

We studied functional endothelial condition in patients with acute myocardial infarction with impaired and preserved renal function. In 34 patients with acute myocardial infarction associated with ST segment rise we carried out a test for endothelium- dependent vasodilatation (EDVD) of brachial artery. Glomerular filtration rate (GFR) was calculated by MDRD formula. Normal renal f unction (calculated GFR ? 60 ml/min/1.73 m2) was observed in 21 patients, renal dysf unction (calculated GFR < 60 ml/min/1.73 m2) was observed in 13 patients. Brachial artery dilatation was significantly higher in patients with normal GFR than in patients with decreased GFR (10.4±5.5% and 6.2%±3.4%, respectively, p=0.03). Mean GFR in patients with endothelial dysf unction (EDVD >10%) was significantly higher than in patients with EDVD < 10% (77.1±13.1 ml/min/ 1.73 m2 and 55.6±22.8 ml/min/1.73 m2, respectively, p=0.02). We observed statistically significant direct moderate positive correlation between calculated GFR and EDVD (R =0.414, p= 0.016). We concluded that there is a direct connection between endothelium condition and renal function in patients with acute myocardial infarction. It can be regarded as one of underlying mechanisms of renal dysfunction connection with cardiovascular mortality risk.

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Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery