Left Ventricular Mass and Intrarenal Arterial Stiffness as Early Diagnostic Markers in Cardiorenal Syndrome Type 5 due to Systemic Sclerosis

Cardiorenal Medicine

Biagio Barbano¹  Antonella Romaniello¹  Antonietta Gigante¹  Francesca Di Mario¹  Rosario Cianci¹  Silvia Quarta¹  Edoardo Rosato¹  Gianluca Di Lazzaro Giraldi¹  Maria Ludovica Gasperini¹  Alessandro Laviano¹  Antonio Amoroso¹  Giuseppe Barilaro¹ 

[1]$$

关键词: Doppler ultrasound;    Echocardiography;    Cardiorenal syndrome;    Systemic sclerosis;    Renal resistive index;    Left ventricular mass;   

DOI  :  10.1159/000442996

学科分类：心脏病和心血管学

来源: S Karger AG

【 摘 要 】

Background: Cardiorenal syndrome type 5 (CRS-5) includes a group of conditions characterized by a simultaneous involvement of the heart and kidney in the course of a systemic disease. Systemic sclerosis (SSc) is frequently involved in the etiology of acute and chronic CRS-5 among connective tissue diseases. In SSc patients, left ventricular mass (LVM) can be used as a marker of nutritional status and fibrosis, while altered intrarenal hemodynamic parameters are suggestive of early kidney involvement. Methods: Forty-two consecutive patients with a diagnosis of SSc without cardiac and/or renal impairment were enrolled to assess whether cardiac muscle mass can be related to arterial stiffness. Thirty subjects matched for age and sex were also enrolled as healthy controls (HC). All patients performed echocardiography and renal ultrasound. Results: Doppler indices of intrarenal stiffness and echocardiographic indices of LVM were significantly increased in SSc patients compared to HC. A positive correlation exists between LVM/body surface area and pulsatile index (p < 0.05, r = 0.36), resistive index (p < 0.05, r = 0.33) and systolic/diastolic ratio (p < 0.05, r = 0.38). Doppler indices of intrarenal stiffness and LVM indices were significantly higher in SSc patients with digital ulcers than in SSc patients without a digital ulcer history. Conclusions: SSc is characterized by the presence of microvascular and multiorgan injury. An early cardiac and renal impairment is very common. LVM and intrarenal arterial stiffness can be considered as early markers of CRS onset. The clinical use of these markers permits a prompt identification of organ damage. An early diagnosis allows the appropriate setting of pharmacological management, by slowing disease progression.

【 授权许可】

Unknown