Left ventricular and renal dysfunction : an exploration of the cardiorenal axis

Both left ventricular dysfunction, and renal dysfunction are world wide public health
problems. In the western countries there is a rising incidence and prevalence of both
conditions, with poor outcomes and high cost. These two conditions do often co-exist and
the concomitant presence of both conditions accumulates risk for morbidity and mortality.
In severe chronic heart failure (CHF), impaired renal function is often present, and is even
a stronger risk marker than functional cardiac parameters, such as left ventricular ejection
fraction or NYHA class.1 On the other hand, left ventricular dysfunction is likely to develop
in patients with chronic renal dysfunction (CRD) and accumulates with worsening renal
function.2 One of the first signs of left ventricular dysfunction in patients with CRD is left
ventricular hypertrophy (LVH). Several studies have demonstrated an association between
renal dysfunction and LVH and the prevalence of LVH increases with worsening of renal
function.3 Finally, several prevalence and longitudinal studies have shown that the well
known age associated decline in renal function is more pronounced in patients with coexisting
cardiovascular risk factors and pre-existing atherosclerotic vascular disease, suggesting
that this decline is not a consistent phenomenon and reflect cardiovascular co-morbidity
rather than normal aging.

	Title and contents
	Chapter 1
	Chapter 2
	Chapter 3
	Chapter 4
	Chapter 5
	Chapter 6
	Chapter 7
	Chapter 8
	Chapter 9
	Chapter 10
	Nederlandse samenvatting
	Dankwoord
	Bibliography
	Complete thesis

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