FP417
ASSOCIATION OF KIDNEY DAMAGE AND SUBCLINICAL LEFT VENTRICULAR DYSFUNCTION IN YOUNG PATIENTS WITH TYPE 1 DIABETES MELLITUS WITHOUT ISCHEMIC HEART DISEASE AND ARTERIAL HYPERTENSION

INTRODUCTION AND AIMS: To study relationship between kidney damage and early markers of left ventricular dysfunction in young patients with Type 1 Diabetes Mellitus (DM) without ischemic heart disease (IHD) and arterial hypertension (AH).

METHODS: In 90 patients with Type 1 DM without IHD and AH, mean age 29.1 ± 8.2 years, 57% of men, disease duration of 6.7 [2; 11] years, early markers and associated clinical signs of heart injury were studied. All patients were performed treadmill test, as well as NT-proBNP, CKD-EPI, albumin/creatinine tests. Echocardiography included a standard study of EF (Simpson method) and longitudinal systolic function of the left ventricle (GLS) using speckle tracking method (VIVD 7 Dimencion, GE).

RESULTS: A total of 58 (64.4%) patients had optimal GFR> 90 ml/min/1.73 m², 27 (30%) patients had a slight decrease in GFR (from 60 to 89 ml/min /1.73 m²), 3 (3,3%) - moderately reduced GFR (45-49 ml/min/1.73 m²) and 2 (2.2%) - significantly reduced GFR (30-44 ml/min/1.73 m²). Twenty five patients (28.2%) had optimal albuminuria, 54 (60%) - moderately increasde; 9 (10%) - highly and 2 (1.8%) considerably highly increased albuminuria. In 24 (26.6%) patients GFR was over 120 ml/min /1.73 m². These patients significantly differed in diabetes duration (2.2 years vs 7.2 years, p <0.001) and in HbA1c value (10.9% vs 9.7%), compared to patients with GFR <120ml/min/1,73 m². Subclinical systolic LV dysfunction, defined as GLS<20%, was observed in 67.7% (61/90), diastolic LV dysfunction - in 10 (16.4%) patients. Multivariate regression analysis showed that albuminuria is one of independent factors, which determine diastolic dysfunction of LV- E/E '(β = 0.22, p <0.001), together with age (β = 0.36, p <0.001) and female sex (β = 0.24, p <0.004), and that GFR closely correlates with GLS (r = 0.28, p <0.006).

CONCLUSIONS: Close associations between albuminuria and diastolic function and between GFR and longitudinal systolic function of the left ventricle were revealed in young patients with type 1 DM without IHD and AH.