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Left ventricular dilatation and subclinical renal damage in primary hypertension

Elena Ratto1, Francesca Viazzi, Barbara Bonino

  • 1I.R.C.C.S. Azienda Ospedaliera Universitaria San Martino-IST, Genova, Italy.

Journal of Hypertension
|November 27, 2014
PubMed

Insights

Left ventricular dilatation in hypertensive patients is linked to subclinical kidney damage, indicated by increased albuminuria and altered intrarenal blood flow. This finding highlights the importance of assessing left ventricular geometry for renal risk stratification.

Area of Science:

  • Cardiology
  • Nephrology
  • Hypertension Research

Background:

  • A novel classification system for left ventricular (LV) geometry, considering LV dilatation and concentricity, has emerged.
  • This classification differentiates subgroups based on hemodynamics, LV function, and cardiovascular prognosis.

Purpose of the Study:

  • To investigate the association between the new LV geometry classification and subclinical renal damage in primary hypertensive patients.
  • Specifically, to examine urine albumin excretion and early intrarenal vascular changes.

Main Methods:

  • Studied 449 untreated hypertensive patients.
  • Classified LV hypertrophy into four patterns (eccentric/concentric, dilated/nondilated) using echocardiography.
  • Assessed albuminuria (albumin-to-creatinine ratio) and intrarenal vascular changes (renal volume to resistive index ratio) via ultrasound and Doppler scan.

Main Results:

  • Concentric dilated LV hypertrophy correlated with higher albuminuria and lower renal vascular indices compared to concentric nondilated hypertrophy.
  • Eccentric dilated LV hypertrophy showed increased microalbuminuria prevalence versus eccentric nondilated LV hypertrophy.
  • Left ventricular chamber dilatation independently predicted subclinical renal damage, irrespective of other factors.

Conclusions:

  • Left ventricular dilatation is significantly associated with subclinical renal damage in hypertensive individuals.
  • These results support previous findings and offer a pathophysiological basis for the poorer prognosis observed in patients with LV dilatation.
Abstract

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