#1796 The impact of metabolic syndrome components on renal function in patients with heart failure

Abstract Background and Aims According to numerous prospective studies, even a slight decrease in renal function is associated with an increased risk of cardiovascular diseases and cardiovascular outcomes, regardless of other risk factors. It has been shown that the prevalence of CVD in the population of patients with reduced renal function is 64% higher than in individuals with normal function. Aim was to determine the frequency and degree of renal function impairment (glomerular filtration rate, creatinine, microalbuminuria) in patients with chronic heart failure (CHF) with mid-range ejection fraction (HFmrEF) depending on the presence and severity of metabolic syndrome (MS) components. Method 197 men with ischemic CHF of functional class II–III (NYHA) aged 40–60 years who had a myocardial infarction (6 months–5 years ago) were examined. The EF level was determined using echocardiography (ESC 2016). The HFmrEF group included patients with an EF of 40%–49%. MS was verified according to the IDF criteria (2009): abdominal obesity (AO), hypertriglyceridemia (TG >1.7 mmol/l), decreased HDL-C (<1.03 mmol/l), arterial hypertension (>130/85 mm Hg), hyperglycemia, or the presence of type 2 diabetes. Patients with HFmrEF were divided into three groups: 28 HFmrEF patients without MS; 28 HFmrEF patients with MS (without type 2 diabetes); 32 HFmrEF patients with MS (+DM2). Results The frequency of microalbuminuria (MAU) increased as the metabolic background became more complex: from 35.7% in the group without MS to 53.6% in the presence of MS and up to 85.7% in the combination of MS and DM2. A progressive decrease in eGFR and an increase in creatinine levels were noted (by 11.3% and 12.7% in group II, by 23.0% and 21.8% in group III relative to patients without MS). As MS worsened, the proportion of patients with stage III chronic kidney disease (CKD) increased: from 0%–7% in the group without MS to 21.4% and 43.7% with MS and MS+DM2, respectively. Conclusion (1) In patients with HFmrEF, metabolic syndrome (especially in combination with type 2 diabetes mellitus) significantly worsens the functional state of the kidneys, which is manifested by an increase in the frequency of MAU and a decrease in eGFR. (2) Correction of risk factors (obesity, hypertriglyceridemia, arterial hypertension, hyperglycemia) seems to be an important direction in slowing the progression of renal dysfunction and preventing cardiovascular complications.

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