Left ventricular diastolic dysfunction and impaired renal function play an important role in the course and prognosis of non-ST-elevation acute coronary syndrome (NSTE-ACS). It is a priority to understand their relationship and connection with coronary atherosclerosis.

OBJECTIVE

To study the association between impaired renal function, left ventricular diastolic dysfunction, and coronary atherosclerosis in NSTE-ACS patients.

MATERIALS AND METHODS

We examined 138 NSTE-ACS patients (113 with impaired renal function and 25 with normal renal function). The patients underwent echocardiography (EchoCG) within 24 hours of admission to the hospital and a kidney test for estimated glomerular filtration rate, daily microalbuminuria, and daily protein excretion. Most patients also underwent coronary angiography, which was scored using the SYNTAX scale.

RESULTS

Patients with or without impaired renal function demonstrated statistically significant differences in EcoCG indicators, including the left atrial volume (34.9 mL/m² vs. 30.5 mL/m², respectively; p<0.0001), diastolic and systolic left and right ventricular indices (p<0.0001), interventricular (7.6 ms vs. 34.9 ms, respectively; p<0.0001) and total intraventricular (93.6 ms vs. 82.0 ms, respectively; p<0.0001) asynchronias. An impaired renal function was associated with more severe coronary atherosclerosis (21.9 vs. 7.9 points on the SYNTAX scale; p<0.0001). We found a strong association between renal and diastolic disorders (p<0.0001) and a statically significant association of coronary atherosclerosis with renal (r=0.695; 0.724; –0.725, p<0.0001) and diastolic (r=0.719, p<0.0001) dysfunctions.

CONCLUSIONS

Left ventricular diastolic dysfunction and impaired renal function are closely associated with coronary atherosclerosis in patients with non-ST-elevation acute coronary syndrome. Worsening left ventricular diastolic function results in progressing coronary atherosclerosis.