Heart failure with preserved left ventricular ejection fraction in patients undergoing hemodialysis

Sažetak: Kardiovaskularne bolesti su najčešći (50–60%) uzrok smrti bolesnika sa hroničnom slabošću bubrega, posebno u njenom završnom stadijumu (ESRD). Simptomatska disfunkcija miokarda leve komore sa očuvanom ejekcionom frakcijom označava klinički sindrom dijastolne srčane insuficijencije. Klinički se ispoljava dispnejom, smanjenom tolerancijom fizičkog napora i brzih promena zapremine cirkulišuće tečnosti. Često „neočekivan” razvoj akutnog plućnog edema predstavlja njenu najtežu kliničku manifestaciju. Dijagnoza se postavlja na osnovu dijaliznoj populaciji prilagođenih (NYHA-R) kriterijuma, potkrepljenih ehokardiografskim parametrima standardnog i tkivnog dopler pregleda leve komore i leve pretkomore. Preventivne mere i konvencionalna farmakoterapija usmerena na kontrolu anemije, sekundarnog hiperparatireoidizma, ishemijske bolesti srca i drugih doprinosećih činilaca, uključujući i pravilan izbor raspoloživih dijaliznih procedura, predstavljaju osnovne principe prevencije i lečenja. Ključne reči: kardiovaskularne bolesti, hemodijaliza, srčana insuficijencija, ehokardiografija.

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