Abstract
Background: To evaluate the association of left ventricular (LV) diastolic function and N-terminal pro-brain natriuretic peptide (NT-proBNP) with renal function in essential hypertension. Methods: In 406 hypertensive patients(mean age, 59±13 years), LV diastolic function was measured by the ratio of early diastolic transmitral E wave velocities to tissue Doppler mitral annulus early diastolic Ea wave velocities (E/Ea) and NT-proBNP was determined. The subjects were classified into three groups: E/Ea≤10 group(n = 85), 10 < E/Ea≤15 group(n = 230) and E/Ea>15 group(n = 91). The renal function was estimated by glomerular filtration rate (GFR) with 99mTc-DTPA. GFR from 30 to 59 ml/min/1.73m2 was defined as Stage 3 CKD. Urinary albumin/creatinine ratio (UACR) served to determine albuminuria. Results: GFR and UACR was significantly correlated with E/Ea and NT-proBNP (P < 0.0001). GFR was lower and UACR was higher in E/Ea≤15 group than in 10 < E/Ea≤15 group or E/Ea≤10 group(P < 0.0001). GFR had significant correlation with age, gender, E/Ea, lgNT-proBNP and lgUACR in multivariate analysis. Patients with higher NT-proBNP were characterized by poorer renal function, while GFR was even lower in patients of LV diastolic dysfunction with higher NT-proBNP. Patients with Stage 3 CKD could be detected by an elevation of NT-proBNP at a cut-off point of 103pg/ml or by increased E/Ea at a cut-off point of 12.4. Conclusions: LV diastolic function, assessed with E/Ea and NT-proBNP is associated with renal function in essential hypertension.
Highlights
Chronic renal dysfunction has a negative effect on cardiac function [1], [2] and patients with chronic kidney disease (CKD) frequently display anomalies of left ventricular (LV) structure and function [3], [4]
Patient Characteristics The subjects were classified into 3 groups based on left ventricular diastolic function: group 1 with normal LV diastolic function of E/E9#10 (n = 48, 23.2%); group 2 with suspected LV diastolic dysfunction of 10,E/E9#15 (n = 109, 52.7%); group 3 with LV diastolic dysfunction of E/E9.15 (n = 50, 24.2%)
The current study investigated the relationship between LV diastolic function and renal function in early essential hypertension
Summary
Chronic renal dysfunction has a negative effect on cardiac function [1], [2] and patients with chronic kidney disease (CKD) frequently display anomalies of left ventricular (LV) structure and function [3], [4]. Both left ventricular systolic and diastolic dysfunction are commonly observed in end-stage renal disease (ESRD), may be associated with subsequent development of cardiac failure and mortality [5], [6]. Statement on diagnosis of heart failure with normal LV ejection fraction from the Heart Failure and Echocardiography Associations of the European Society of Cardiology, suggests that NTproBNP can be used as a biomarker for heart failure [13]
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