| Left ventricular geometry and renal function in hypertensive patients with diastolic heart failure. | |
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MedLine Citation:
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PMID: 17261425 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The objective is to define the relationship between cardiac geometry and renal function in hypertensive subjects with and without diastolic heart failure (DHF). METHODS: This is a prospective observational study in a tertiary-care teaching institute in a 15-month period of consecutive hospitalized hypertensive patients. Patients on dialysis therapy or with atrial fibrillation, systolic heart failure, gross proteinuria, and glomerular diseases were excluded. Two-dimensional echocardiography was performed and stable glomerular filtration rate (GFR) was calculated by using the Modification of Diet in Renal Disease formula. Patients were classified into stage 1 to 5 chronic kidney disease (CKD). RESULTS: Five hundred forty hypertensive patients were separated into 2 groups: 286 patients with DHF and 254 patients without DHF. Mean age was 69.1 +/- 13.7 (SD) years in general. In patients with DHF, from stages 1 to 5 CKD, there was a significant graded increase in left ventricular mass index (from 117.3 to 162.4 g/m(2)) and relative wall thickness (from 0.42 to 0.52) and a significant graded decrease in aortic cusp separation (from 1.85 to 1.55 cm). Among echocardiographic variables, left ventricular mass index and relative wall thickness were associated inversely and aortic cusp separation was associated directly with GFR. In the absence of DHF, only left ventricular mass index was associated inversely with GFR, suggesting a prominent role of aortic cusp separation and relative wall thickness in the variability in GFR in patients with DHF through a hemodynamic disturbance. CONCLUSION: Hemodynamic alterations have a prominent role in the variability of GFR in patients with CKD with DHF. Adverse cardiac geometry is linked to the severity of CKD in hypertensive patients, raising the possibility of preserving both cardiac and renal function by means of hypertension control. |
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Authors:
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Farsad Afshinnia; Samuel Spitalewitz; Shyan-Yih Chou; David Z Gunsburg; Hal L Chadow |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: 49 ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2007 Feb |
Date Detail:
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Created Date: 2007-01-30 Completed Date: 2007-03-14 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: United States |
Other Details:
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Languages: eng Pagination: 227-36 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine at Memorial Medical Center, Sutter-Gould Medical Foundation Inc, Modesto, CA, USA. afshinnia@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Blood Pressure / physiology* Cross-Sectional Studies Diastole / physiology Female Heart Failure / complications, physiopathology* Humans Hypertension / complications, physiopathology* Hypertrophy, Left Ventricular / complications, physiopathology* Kidney / physiology* Kidney Function Tests Male Middle Aged Prospective Studies Ventricular Function, Left / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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