RADIONUCLIDE METHODS OF DIAGNOSIS IN ASSESSMENT OF INTERRELATIONSHIP BETWEEN THE FUNCTION OF THE CARDIOVASCULAR SYSTEM AND KIDNEYS IN PATIENTS WITH PREVIOUSLY ENDURED MYOCARDIAL REVASCULARIZATION

Vesnina J.V., Arsenyeva Yu.A., Lishmanov Yu.V.
Federal Facility "Scientific Research Institute of Cardiology of the Tomsk Scientific Centre of the Siberian Branch of the Russian Academy of Medical Sciences, Tomsk, Russia;
Scientific Research Institute of Emergency Ambulance Care named after N.V. Sklifosovskii, Moscow, Russia

A steady increase in the number of patients diagnosed with chronic cardiac insufficiency determines the importance of studying in such patients the renal function for comprehen-sive analysis of the incidence rate and mechanisms of the cardiorenal continuum. Radionuclide methods of diagnosis make it possible to obtain versatile information about the functional state of both the cardiovascular and urinary systems of the body.

Radionuclide methods of study were used to prospectively assess the state of the cardiopulmonary haemodynamics and renal functional activity in patients with CAD after previously endured myocardial revascularization.

The authors examined a total of twenty-nine patients suffering from coronary artery disease (CAD) (mean age 51.97±1.32 years) and having developed the NYHA functional class II-III circulatory insufficiency. All the patients were subjected to radiocardiopulmonography (RCPG) with 99mTc-pertechnetate and to dynamic radionuclide renoscintigraphy with 99mTc-DTPA before and after coronary artery bypass grafting (CABG). Fourteen patients were examined 13.0±0.4 months after surgical management.

Prior to CABG, the parameters of the cardiopulmonary haemodynamics in the examined patients had considerable deviations from the normal values, resulting from a decrease in the pumping function of the heart. Prior to surgical management, 83% of the patients were found to have a various-degree decrease in the glomerular filtration rate. Restoration of the coronary blood flow at early terms following CABG along with improved perfusion in the examined patients was accompanied and followed by a positive change in a series of parameters of the cardiopulmonary haemodynamics. One year after direct myocardial revascularization, the patients with circulatory insufficiency were found to have certain relationship between the impairments of the central haemodynamics parameters and the development of renal function impairment.

Hence, radionuclide methods of diagnosis should be used while monitoring the patients with circulatory insufficiency for the purposes of timely detection and correction of the cardiorenal syndrome.

KEY WORDS: coronary artery bypass grafting, circulatory insufficiency, radionuclide methods of diagnosis.

P. 67

« Back