Echocardiographic markers of left ventricular dysfunction among men with uncontrolled hypertension and stage 3...

Area of Science:

• Cardiology
• Nephrology
• Hypertension Research

Background:

• Arterial hypertension (AH) management guidelines stress diagnosing subclinical organ damage for cardiovascular risk assessment.
• Uncontrolled AH with chronic kidney disease (CKD) poses significant cardiovascular risks.
• Evaluating left ventricular hypertrophy (LVH), geometry, and systolic/diastolic dysfunction in men with uncontrolled AH and CKD stages 3A/3B is essential.

Purpose of the Study:

• To assess the prevalence of LVH, LV geometry, and systolic/diastolic dysfunction in men with uncontrolled AH and CKD stages 3A and 3B.
• To compare echocardiographic parameters between CKD stage 3A and 3B in hypertensive men.
• To investigate the relationship between estimated glomerular filtration rate (eGFR) and cardiac abnormalities.

Main Methods:

• Included 256 men with essential AH.
• Calculated eGFR using the simplified MDRD equation.
• Assessed left ventricular structure and function via echocardiography.

Main Results:

• Only 17.2% of patients achieved target blood pressure.
• CKD was present in 26.2% of subjects (19.14% stage 3A, 7.03% stage 3B).
• Patients in CKD stage 3B exhibited significantly higher LVEDD, LA, RWT, LVMI, and LVH prevalence, including eccentric hypertrophy, compared to stage 3A. LVEF and E/A ratio decreased with declining renal function.

Conclusions:

• Findings support dividing CKD stage 3 into substages 3A and 3B based on eGFR and echocardiographic findings.
• The observed relationships between eGFR and LV abnormalities underscore the importance of this substage division.
• Intensified therapeutic regimens are crucial for CKD stage 3B patients from both cardiological and nephrological viewpoints.