Related Experiment Video
Updated: Feb 1, 2026
Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
Published on: June 6, 2025
Left Ventricular Strain and Relaxation Are Independently Associated with Renal Cortical Perfusion in Hypertensive
Arkadiusz Lubas1, Robert Ryczek2, Artur Maliborski3
1Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland.
Insights
Cardiac function significantly impacts kidney perfusion in hypertensive patients with chronic kidney disease. Reduced left ventricular global longitudinal strain better predicts declining renal perfusion than ejection fraction.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Background:
- Renal perfusion is crucial for kidney function and is influenced by cardiac performance.
- Hypertension and chronic kidney disease (CKD) often coexist, complicating patient management.
- Understanding the link between cardiac mechanics and renal perfusion is vital for these patients.
Purpose of the Study:
- To evaluate how cardiac function, specifically left ventricular contractility and relaxation, affects renal cortical perfusion.
- To investigate this relationship in patients with both hypertension and stable CKD undergoing pharmacological treatment.
Main Methods:
- Sixty-three patients with hypertension and CKD were assessed.
- Methods included serum cystatin C for estimated glomerular filtration rate (eGFR), ambulatory blood pressure monitoring, carotid intima-media thickness (cIMT), and echocardiography with speckle tracking imaging.
- Echocardiography measured global longitudinal strain (GLS), inferior vena cava diameter (VCI), and mitral inflow velocities (E/A, E/E'). Renal cortical perfusion was measured using ultrasound dynamic tissue perfusion.
Main Results:
- Renal cortical perfusion showed significant correlations with age, eGFR, cIMT, GLS, left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), and diastolic parameters (E/A, E/E').
- No significant correlation was found with VCI or right ventricle echocardiographic parameters.
- Multivariable regression identified eGFR, E/E', and GLS as independent predictors of renal cortical perfusion (r² = 0.44, p < 0.001).
Conclusions:
- Left ventricular strain and relaxation significantly and independently influence renal cortical perfusion in hypertensive CKD patients.
- Decreased global longitudinal strain is a more sensitive indicator of declining renal cortical perfusion than left ventricular ejection fraction.
Abstract:
Renal perfusion, which depends on cardiac function, is a factor conditioning the work of kidneys. The objective of the study was to assess the influence of cardiac function, including left ventricular contractility and relaxation, on renal cortical perfusion in patients with hypertension and chronic kidney disease treated pharmacologically. There were 63 patients (7 F and 56 M; aged 56 ± 14) with hypertension and stable chronic kidney disease enrolled into the study. Serum cystatin C, with estimated glomerular filtration rate (eGFR), ambulatory blood pressure monitoring, carotid intima-media thickness (cIMT), echocardiography with speckle tracking imaging and the calculation of global longitudinal strain (GLS), diameter of vena cava inferior (VCI), and an ultrasound dynamic tissue perfusion measurement of the renal cortex were performed. We found that the renal cortical perfusion correlated significantly with age, renal function, cIMT, GLS, left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), diastolic peak values of early (E) and late (A) mitral inflow velocities ratio (E/A) and E to early diastolic mitral annular tissue velocity (E/E'), but not with VCI, or the right ventricle echocardiographic parameters. In multivariable regression analysis adjusted to age, only eGFR, E/E', and GLS were independently related to renal cortical perfusion (r 2 = 0.44; p < 0.001). In conclusion, the intensity of left ventricular strain and relaxation independently influence renal cortical perfusion in hypertensive patients with chronic kidney disease. A reduction in left ventricular global longitudinal strain is superior to left ventricular ejection fraction in the prediction of a decline in renal cortical perfusion.
Related Concept Videos
01:21Introduction to Test of Independence
The test statistic for a test of independence is similar to that of a goodness-of-fit test:
01:16Hypothesis Test for Test of Independence
H0: The two variables (factors)...
01:29Relaxation of Skeletal Muscles
When an action potential reaches the axon terminal, it depolarizes the membrane and opens voltage-gated sodium channels. Sodium ions enter the cell, further depolarizing the presynaptic membrane. This depolarization causes voltage-gated calcium channels to open....
02:03Law of Independent Assortment
01:28Classification of Skeletal Muscle Relaxants
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
01:18Independent and Dependent Sources
Independent voltage or current sources supply a fixed amount of voltage or current, respectively, which is unaffected by other elements within the circuit. These are represented using specific symbols. Independent voltage sources are symbolized with polarities (+ and -), indicating the direction of the...