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Influence of chronic renal insufficiency on left ventricular diastolic function in hypertensives without left

Emilio Nardi1, Santina Cottone, Giuseppe Mulè

  • 1Chair of Internal Medicine, Division of Internal Medicine, Nephrology and Hypertension, Department of Internal Medicine, Cardiovascular and Renal Diseases, University of Palermo, Palermo - Italy. emilionardi@virgilio.it

Journal of Nephrology
|June 9, 2007
PubMed

Insights

Patients with chronic renal insufficiency (CRI) experience significant diastolic dysfunction, independent of left ventricular hypertrophy (LVH). This highlights other factors contributing to heart issues in mild to moderate kidney disease.

Area of Science:

  • Cardiology
  • Nephrology
  • Echocardiography

Background:

  • Patients with chronic renal insufficiency (CRI) face elevated cardiovascular risk, particularly from hypertension, left ventricular hypertrophy (LVH), and diastolic dysfunction.
  • While established in end-stage renal disease, data on mild to moderate CRI, especially regarding diastolic function without LVH, is limited.

Purpose of the Study:

  • To assess left ventricular (LV) structure and diastolic function in hypertensive patients with mild to moderate CRI compared to hypertensive individuals with normal renal function.
  • To investigate the relationship between renal function and LV alterations in the absence of LVH.

Main Methods:

  • A cross-sectional study comparing hypertensive patients with CRI and essential hypertension (EH) without LVH.
  • Utilized mitral inflow and tissue Doppler echocardiography to evaluate LV structure and diastolic function.

Main Results:

  • CRI patients exhibited increased LV end-diastolic diameter, end-systolic diameter, and LV mass index (LVMI) compared to EH patients.
  • The CRI group demonstrated significantly impaired diastolic function indexes, including lower E-wave velocity and E/A ratio, and prolonged isovolumic relaxation time.
  • Renal function emerged as an independent predictor of LVMI and diastolic function, irrespective of other cardiovascular risk factors.

Conclusions:

  • Mild to moderate CRI is associated with significant diastolic dysfunction, partially independent of LVMI.
  • Factors beyond LVMI and blood pressure play a crucial role in the early development of diastolic dysfunction in CRI patients.
Abstract

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