PS-C14-12: RIGHT VENTRICLE SYSTOLIC FUNCTION IN HYPERTENSIVE NEPHROPATHY PATIENTS

Abstract

Objective: To investigate right ventricular systolic function in chronic kidney disease (CKD) patients. Design and method: We examined 15 essential hypertensive subjects and 34 untreated non-diabetic essential hypertensive patients with II and III stage of hypertensive CKD. Echocardiography and ambulatory blood pressure (BP) monitoring was performed for all patients. Glomerular filtration rate (GFR) assessment was based on CKD-EPI formula. Patients underwent a two-dimensional Doppler-coupled echocardiography with determination of right ventricular (RV) systolic function with conventional echocardiographic methods: RV fractional area change, Tricuspid Annular Plane of Systolic Excursion (TAPSE), Tricuspid annular S’ velocity of the lateral tricuspid annulus, RV Tei index. Right ventricle free wall longitudinal strain (RVFWLS) obtained by speckle-tracking. Results: CKD patients and essential hypertensive subjects had no significant difference between RV systolic function values evaluated with RV fractional area change and RV Tei index. At the same time we observed significantly lower values of TAPSE and Tricuspid annular S’ velocity of the lateral tricuspid annulus (p < 0.05 in both cases) in CKD patients. Highly significant RVFWLS decline was observed in CKD patients comparing to essential hypertensive subjects (p < 0.01). In univariate correlation analysis GFR was more closely related to RVFWLS (r = 0,523, p < 0.01) comparing to Tricuspid annular S’ velocity of the lateral tricuspid annulus and TAPSE (r = 0,371, p < 0.05 and r = 0,293, p < 0.05 respectively). Conclusion: Hypertensive nephropathy patients have early impairment of RV systolic function detected by significantly lower Tricuspid annular S’ velocity as well as TAPSE and highly significant RVFWLS decline comparing to essential hypertensive subjects. There was more significant relationship between GFR and RVFWLS rather than Tricuspid annular S’ velocity of the lateral tricuspid annulus and TAPSE.