FACTORS ASSOCIATED WITH DECREASED LONGITUDINAL FUNCTION IN RENAL FAILURE HYPERTENSIVE PATIENT

Abstract

Objective: Although the combination of arterial hypertension and renal insufficiency (RI) increases the risk of left ventricular (LV) dysfunction, the impact of renal insufficiency on LV geometry and subclinical dysfunction in hypertensive patients with normal ejection fraction (EF) has rarely been evaluated. The objective of this work is to study the correlation between renal failure and the early onset of hypertensive heart disease, as well as the determination of the associated factors influencing this subclinical heart attack. Design and method: A cross-sectional analytical study was carried out in 200 hypertensive patients recruited from the outpatient cardiology consultation, divided into: 100 patients with and 100 without concomitant renal failure. Hypertensive patients with or without renal failure underwent cardiac echocardiography coupled with an evaluation of the global longitudinal deformity (GLS) of the LV Results: Among the 200 patients with hypertension (mean age 61.7 ± 8.5 years) and EF >55%, 100 had associated renal impairment. Patients with IR had more diabetes(60.5%vs. 36%, p = 0.002), higher BP levels (160±19/81±13 vs. 139±14/74±11, p = 0.000), higher VG mass index (116.05±31.1vs. 110.6±24.8g/m2, p = 0.007) andhigher relative wall thickness (0.46±0.08 vs. 0.44±0.07 p = 0.0001). They more frequently had concentric remodeling (28(28%) vs. 19(19%), p = 0.008), concentric hypertrophy (46(46%) vs. 38(38%), p<0.0001), pressures filling volumes (7.4±3.0vs. 6.0±2.1, p = 0.001), indexed left atrial volumes greater than 28 mL/m2 (18.8±8.1 vs.15.5±6.0, p = 0.004), and reduced GLS less than 18% (70% vs. 48%, p < 0.0001). After adjusting for BP and diabetes, IR remains an independent determinant of GLS decline (OR = 2.26, 95% CI 1.11–4.61, p = 0.023). Conclusions: Left ventricular geometry and subclinical LV function assessed with GLS are more impaired in hypertensive patients with renal failure. Preventive approaches to control the risk of onset of renal failure in hypertensive patients should be emphasized.