Cardiac Structure and Function Among Patients With Heart Failure With Reduced Ejection Fraction and Kidney Disease.

Area of Science:

• Cardiology
• Nephrology
• Medical Imaging

Background:

• Kidney disease (KD) is a frequent comorbidity in patients with heart failure with reduced ejection fraction (HFrEF).
• Understanding the relationship between cardiac structure/function and KD is crucial for managing HFrEF patients.

Purpose of the Study:

• To investigate cardiac structure and function measures in relation to prevalent and incident kidney disease in HFrEF patients.
• To identify echocardiographic predictors of kidney disease development in this population.

Main Methods:

• Retrospective analysis of 1138 HFrEF patients (left ventricular ejection fraction ≤ 45%).
• Patients stratified into groups: no KD, incident KD, and prevalent KD.
• Echocardiographic parameters assessed: LVEF, global longitudinal strain (GLS), tricuspid annular plane systolic excursion (TAPSE), and E/e' ratio.
• Cox regression analysis used to assess associations with incident KD.

Main Results:

• At baseline, impaired LVEF, GLS, TAPSE, and E/e' ratio were observed across KD severity groups.
• All four echocardiographic measures were associated with incident KD in univariable analysis.
• LVEF, TAPSE, and E/e' ratio remained significant predictors of incident KD after adjustment.

Conclusions:

• Impaired cardiac function, assessed by GLS, LVEF, TAPSE, and E/e' ratio, is associated with prevalent and incident KD in HFrEF patients.
• LVEF, TAPSE, and E/e' ratio are independent predictors of incident KD, highlighting their prognostic value.