Cardiac function in renovascular hypertensive patients with and without renal dysfunction

Area of Science:

• Cardiology
• Nephrology
• Hypertension Research

Background:

• Hypertension negatively impacts left ventricular (LV) diastolic and systolic function.
• Inflammation and neurohumoral activation may exacerbate these effects.
• Renovascular hypertension (RVHT) may be associated with a higher prevalence of LV diastolic dysfunction compared to essential hypertension (EHT).

Purpose of the Study:

• To investigate the hypothesis that LV diastolic dysfunction is more prevalent in patients with RVHT compared to EHT.
• To compare cardiac function and structure between RVHT and EHT patients.

Main Methods:

• Retrospective analysis of hypertensive patients who underwent renal imaging and cardiac echocardiography.
• Patients were categorized into RVHT (n=75) and EHT (n=69) groups based on the presence of significant renovascular disease.
• Cardiac function, structure, and renal function (serum creatinine, eGFR) were compared between groups.

Main Results:

• RVHT patients exhibited higher systolic blood pressure, E/e' ratio, and concentric hypertrophy, with lower eGFR compared to EHT patients.
• LV diastolic dysfunction was significantly more prevalent in RVHT patients, even after multivariable adjustment (RR 1.70, 95% CI 1.05-2.90).
• Severe renal dysfunction in RVHT patients was associated with greater impairments in both systolic and diastolic cardiac function.

Conclusions:

• Cardiac structure and diastolic function are impaired in RVHT patients compared to EHT patients, independent of several covariables.
• RVHT associated with significant renal dysfunction exacerbates LV hypertrophy and cardiac systolic and diastolic dysfunction.
• Identifying RVHT and renal dysfunction is crucial for developing targeted management strategies.