[CORRELATION ANALYSIS BETWEEN CLINICO-LABORATORY AND INSTRUMENTAL INDICATORS OF CARDIAC INVOVLVEMENT IN YOUNG ADULTS SUFFERING FROM ACUTE POST-STREPTOCOCCAL GLOMERULONEPHRITIS WITH ACUTE RENO-CARDIAL SYNDROME].Georgian Med News. 2020 AprGM
Study goal - to study the characteristics of the development of acute reno-cardial syndrome (ARCS) and correlation analysis between clinic-laboratory and instrumental indicators of cardiac involvement in young adults in acute post-streptococcal glomerulonephritis (APSG) with acute nephritic syndrome (ANS) complicated by acute kidney injury (AKI) and without it, to identify the role of the etiological factor on the course of APSG. 220 male patients with APSG with ANS aged 18-20 were examined. The patients were divided into 2 groups based on the functional state of kidneys. The first group included 140 patients with APSG without ANS, the second group included 80 patients with AKI. Impairment of cardiovascular function was observed in all 220 patients. In 71.4% of group I patients bradycardia occurred, in 83.7% of group II patients, in addition to bradycardia, extrasystolic arrhythmia was observed. Lung congestion occurred in 17.8% of patients of group I and in all patients of group II. ECG and Echocardiography studies conducted during the cardiac asthma attacks occurred as a decrease of voltage, broadening of the P wave, lengthening of the PQ interval, broadening of the QRS complex, dilatations of the right and left atrium. Thus in the development of acute reno-cardial syndrome (ARCS) the degree of manifestation of hypervolemia with hypertension, as a result of active immune inflammation of the glomerular apparatus with the development of AKI, plays the main role in the development of ARCS with APSG. ARCS is clinically manifested by cardiac asthma attacks, bradycardia, and rhythm disorders. The severity of clinical manifestations of AKI and ARCS correlates with the degree of macrohematuria, GFR decrease, complement C3 fraction, monocyte level and increased levels of CEC (ЦИК), ASLO. As a rule ARCS in case of APSG with ANS in young adults has a successful outcome. There is a direct correlation between the indicators of the etiological factor and clinical manifestation of the disease. The course was severe in case of previously occurred streptodermа.