Right ventricle, pulmonary pressure and their relationship with renal function in patients with overweight and obesity

Мұқаба

Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Background. Overweight, obesity and chronic kidney disease (CKD) are urgent problems of modern medicine.

Objective. Analysis of the relationship between the right ventricle (RV) function, pulmonary pressure and the state of the kidneys in patients with overweight and obesity.

Material and methods. An analysis of clinical, laboratory and echocardiographic data of 305 patients with overweight (n=155) and obesity (n=150), whose mean age was 54.7±11.7 years, was performed. Patients with functional class III–IV chronic heart failure, fever, Lower extremity varicose vein disease, a history of thromboembolic complications, type 1 diabetes mellitus (DM1), liver cirrhosis, nephrotic syndrome, patients on renal replacement therapy, and residents of high-mountain areas were excluded from the study.

Results. Compared with overweight patients, obese patients were more likely to have arterial hypertension (58.0%), DM2 (22.0%) and comorbid diseases (31.3%). This group also had higher diastolic blood pressure (89±11 mmHg vs. 86±11 mmHg; p<0.05), venous blood glucose levels (7.00±3.16 mmol/l vs. 5.76±2.25 mmol/l; p<0.05), triglycerides: 1.66 [1.13; 2.26] mmol/l vs. 1.36 [0.95; 2.25] mmol/l (p<0.05), C-reactive protein – 3.2 [1.6; 7.9] mg/l vs. 2.0 [0.6; 5.3] mg/L (p<0.05), RV size – 2.23±0.40 cm versus 2.09±0.31 cm (p<0.05), pulmonary artery diameter – 2.37±0.38 cm versus 2.24±0.25 cm (p<0.05) and pulmonary systolic pressure – 32.7±12.3 mmHg versus 29.4±6.76 mmHg (p<0.05). Serum calcium level was lower (2.10±0.41 mmol/L versus 2.21±0.24 mmol/L; p<0.05). A direct correlation was established between RV wall thickness and proteinuria (r=0.342; p<0.05); cystatin C and the size of the right ventricle (r=0.190; p=0.002), its wall thickness (r=0.145; p=0.019), the diameter of the pulmonary artery (r=0.318; p=0.005), and the level of systolic pulmonary pressure (r=0.264; p=0.005). An inverse correlation was recorded between the estimated glomerular filtration rate (eGFR) and the size of the right ventricle (r=-0.254; p=0.005), its wall thickness (r=-0.184; p=0.003), the diameter of the pulmonary artery (r=-0.341; p=0.005), and the level of systolic pulmonary pressure (r=-0.285; p=0.005).

Conclusion. In patients with overweight and obesity, significant relationships were found between the parameters of the right ventricle and pulmonary pressure with the kidney filtration function (cystatin C, GFR).

Толық мәтін

Рұқсат жабық

Авторлар туралы

Ilkhom Murkamilov

I.K. Akhunbaev Kyrgyz State Medical Academy named after; Salymbekov University

Хат алмасуға жауапты Автор.
Email: murkamilov.i@mail.ru
ORCID iD: 0000-0001-8513-9279

Dr.Sci. (Med.), Associate Professor at the Department of Faculty Therapy, Director of the Multidisciplinary Medical Center "Doc University Clinic"

Қырғызстан, Bishkek; Bishkek

Kubanych Aitbaev

Research Institute of Molecular Biology and Medicine

Email: aitbaev.kuban1940@gmail.com
ORCID iD: 0000-0003-4973-039X

Dr.Sci. (Med.), Professor, Head of the Department of Pathological Physiology

Қырғызстан, Bishkek

Viktor Fomin

Sechenov First Moscow State Medical University (Sechenov University)

Email: fomin_vic@mail.ru
ORCID iD: 0000-0002-2682-4417

Dr.Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Faculty Therapy No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, Vice-Rector for Innovation and Clinical Activities

Ресей, Moscow

Furkat Yusupov

Osh State University

Email: furcat_y@mail.ru
ORCID iD: 0000-0003-0632-6653

Dr.Sci. (Med.), Professor, Head of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty

Қырғызстан, Osh

Tursunoy Yusupova

Osh State University

Email: yusupova_tursunoy_f@mail.ru
ORCID iD: 0000-0002-8502-2203

Clinical Resident of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty

Қырғызстан, Osh

Zulkhumor Yusupova

Osh State University

Email: zulkhumor.yusupova.f_05@mail.ru
ORCID iD: 0000-0001-7621-1128

4th year student at the Medical Faculty

Қырғызстан, Osh

Gulzat Duysheeva

I.K. Akhunbaev Kyrgyz State Medical Academy named after

Email: guzyu_88@mail.ru

Teaching Assistant at the Department of Faculty Therapy

Қырғызстан, Bishkek

Shavkat Khakimov

Salymbekov University

Email: hakimovshaki13@gmail.com
ORCID iD: 0009-0004-0437-0188

Head of the Department of Intensive Care Medicine, Therapy and Diagnostics

Қырғызстан, Bishkek

Islombek Abdurakhmanov

Saint Petersburg State University

Email: ali_islam95@mail.ru
ORCID iD: 0009-0006-0660-0113

Therapist, Researcher, City Polyclinic No.120

Ресей, Saint Petersburg

Zhaloliddin Solizhonov

Kazan State Medical University

Email: jaloliddinsolijonov44@gmail.com
ORCID iD: 0009-0003-0078-0609

6th-year student of the Faculty of Medicine

Ресей, Kazan

Daniyar Ymankulov

Medical Center "Green Clinic"

Email: ymankulov9595@mail.ru
ORCID iD: 0009-0000-4975-1196

Doctor-Researcher, Plastic Surgeon

Қырғызстан, Bishkek

Komil Khabibullaev

I.K. Akhunbaev Kyrgyz State Medical Academy named after

Email: khabibullaevkomil2001@gmail.com
ORCID iD: 0009-0004-5508-8019

6th year student of the Faculty of Medicine

Қырғызстан, Bishkek

Әдебиет тізімі

  1. Dang K., Wang X., Hu J., et al. The association between triglyceride-glucose index and its combination with obesity indicators and cardiovascular disease: NHANES 2003-2018. Cardiovasc. Diabetol. 2024;23(1):8. Doi: https://doi.org/10.1186/s12933-023-02115-9.
  2. Sebastian S.A., Padda I., Johal G. Cardiovascular-Kidney-Metabolic (CKM) syndrome: A state-of-the-art review. Curr. Probl. Cardiol. 2024;49(2):102344. Doi: https://doi.org/10.1016/j.cpcardiol.2023.102344.
  3. Bobkova I.N., Gussaova S.S., Stavrovskaya E.V., et al. Serum resistin levels in patients with morbid obesity. Clin. Pharmacol. Ther. 2019;28(4):24–9 (In Russ.)]. Doi: https://doi.org/10.32756/0869-5490-2019-4-24-29.
  4. Gussaova S.S., Bobkova I.N., Yashkov Y.I., et al. Changes in metabolic parameters and glomerular filtration rate in patients with morbid obesity after bariatric surgery. Ter. Arkh. 2020;92(6):53–9 (In Russ.). Doi: https://doi.org/10.26442/00403660.2020.06.000674.
  5. Berglund F., Piña P., Herrera C.J. Right ventricle in heart failure with preserved ejection fraction. Heart. 2020;106(23):1798–804. Doi: https://doi.org/10.1136/heartjnl-2020-317342.
  6. Artham S.M., Lavie C.J., Patel H.M., et al. Impact of obesity on the risk of heart failure and its prognosis. Cardiometab. Syndr. 2008;3(3):155–61.
  7. Hubesch G., Dewachter C., Chomette L., et al. Early Alteration of Right Ventricle-Pulmonary Artery Coupling in Experimental Heart Failure With Preserved Ejection Fraction. J. Am. Heart Assoc. 2024;13(11):e032201. Doi: https://doi.org/10.1161/JAHA.123.032201.
  8. Chahal H., McClelland R.L., Tandri H., et al. Obesity and right ventricular structure and function: the MESA-Right Ventricle Study. Chest. 2012;141(2):388–95. Doi: https://doi.org/10.1378/chest.11-0172.
  9. Clinical recommendations. Chronic kidney disease (CKD). Nephrology (Saint-Petersburg). 2021;25(5):10–82 (In Russ.). Doi: https://doi.org/10.24884/1561-6274-2021-25-5-10-82.
  10. Tomilina N.A., et al. Chronic kidney disease. Select. Chapters Nephrol. M., 2017. T. 136 (In Russ.)
  11. Narcissova G.P. The role of the right ventricle in the pathology of the cardiovascular system. Pathol. Blood Circulat. Cardiac Surg. 2014;18(1):32–6 (In Russ.).
  12. Chuchalin A.G. The right-sided heart failure. Rus. Pulmonol. 2019;29(2):135–47 (In Russ.). Doi: https://doi.org/10.18093/0869-0189-2019-29-2-135-147.
  13. Solomakhina N.I., Kutyrina I.M., Rudenko T.E., Vaslyeva M.P. Pulmonary hypertension as a sign of heart involvement in chronic kidney disease progression. Clin. Nephrol. 2013;6:4–7 (In Russ.).
  14. Gubkin S.V., Yudina O.A., Kalinovskaya E.I., Chudilovskaya E.N. Morphological features of the state of microcirculation of the ventricular myocardia in extreme obesity. Military Med. 2024;1:11–4 (In Russ.). Doi: https://doi.org/10.51922/2074-5044.2024.1.11.
  15. Rudenko T.E., Vasil'eva M.P., Solomakhina N.I., Kutyrina I.M. Risk factors for pulmonary hypertension at the predialysis stage of chronic kidney disease. Ther. Arch. 2016;88(6):339 (In Russ.). Doi: https://doi.org/10.17116/terarkh201688633-39.
  16. Gasanov M.Z., Kolomyitseva M.N., Batyushin M.M. The Role of Uremic Intoxication in the Development of Cardiovascular Remodeling in Patients with Chronic Kidney Disease Stages 3a–5d. Rus. Arch. Int. Med. 2021;11(5):3709 (In Russ.). Doi: https://doi.org/10.20514/2226-6704-2021-11-5-370-379.

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
2. Fig. 1. Comparative characteristics of the concentration of serum cystatin C

Жүктеу (49KB)
3. Fig. 2. Relationship between pancreatic thickness and proteinuria

Жүктеу (69KB)