P896Effects of tafamidis in patients with transthyretin amyloid cardiomyopathy

Abstract Background Transthyretin amyloid cardiomyopathy (ATTR-CA) is caused by deposition of amyloid fibrils in the myocardium. The deposition occurs when transthyretin (TTR) becomes unstable and misfolds. Tafamidis is a kinetic stabilizer of TTR that prevents tetramer dissociation and amyloidogenesis by TTR. Methods Eighteen patients with diagnosis of ATTR-CA (hATTR or wtATTR) from our national amyloidosis registry were treated with 20 mg of tafamidis for a period of six months. In our explorative analysis we aimed to evaluate the effects of tafamdis by changes from baseline of the serum NT-proBNP concentration, 6-minute walking distance, as well as cardiac structure and function. Results The exploratory analysis showed a decrease in serum NT-proBNP concentration in tafamidis treated patients, compared to increase in untreated patients (median difference, −481.0 pg/mL). Tafamidis improved the walking distance during the 6-minute walk test at month six, compared to baseline (mean, 31.25 m). Echocardiographic findings revealed an improvement of the global longitudinal strain (mean, 0.77%), a decrease in left atrial size (mean, −1.65 mm) and a decrease in left ventricular size (mean, −4.13 mm) in tafamidis treated patients compared to untreated patients. Due to insufficient power the results did not differ significantly between tafamidis treated patients and untreated patients. Change from baseline Tafamidis No treatment Treatment Difference p-value Cardiac Biomarkers n=18 n=15 NT-proBNP, ng/L Baseline, median 2740.0 2835.0 CFB to 6 months, median −207.0 274.0 −481.0 0.329 Functional Status n=8 n=7 6MWT, m Baseline, mean 441.00 420.50 CFB to 6 months, mean 31.25 −16.50 +47.75 0.373 Echocardiogram n=17 n=15 LA, mm Baseline, mean 63.41 61.33 CFB to 6 months, mean −1.65 0.60 −2.25 LV, mm Baseline, mean 44.13 41.80 CFB to 6 months, mean −4.13 0.33 −4.46 0.075 LV wall thickness, mm Baseline, mean 22.06 18.47 CFB to 6 months, mean 0.68 −0.60 +1.28 0.055 Longitudinal strain, % Baseline, mean −10.66 −12.42 CFB to 6 months, mean 0.77 −1.03 +1.80 0.652 MRI n=7 n=6 ECV, % Baseline, mean 52.26 44.22 CFB to 6 months, mean 0.81 3.70 − 2.89 0.493 LV mass, g Baseline, mean 187.71 170.33 CFB to 6 months, mean 24.29 19,67 +4.62 0.612 Conclusion Treatment with tafamidis for a period of six months in patients with ATTR-CA leads to positive effects on NT-proBNP level, 6-minute walking distance, as well as cardiac structure and function compared to untreated patients.

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HIV and pericardial fat are associated with abnormal cardiac structure and function among Ugandans

Heart ◽

10.1136/heartjnl-2019-315346 ◽

2019 ◽

Vol 106 (2) ◽

pp. 147-153 ◽

Cited By ~ 6

Author(s):

Jonathan Buggey ◽

Leo Yun ◽

Chung-Lieh Hung ◽

Cissy Kityo ◽

Grace Mirembe ◽

...

Keyword(s):

Disease Risk ◽

Cardiovascular Disease Risk ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Structure And Function ◽

People Living With Hiv ◽

Cardiac Structure ◽

Pericardial Fat ◽

Cardiac Structure And Function ◽

And Function

ObjectivesTo examine the relationship between pericardial fat (PCF) and cardiac structure and function among HIV-infected patients in the sub-Saharan African country of Uganda. People living with HIV (PLHIV) have altered fat distribution and an elevated risk for heart failure. Whether altered quantity and radiodensity of fat surrounding the heart relates to cardiac dysfunction in this population is unknown.MethodsOne hundred HIV-positive Ugandans on antiretroviral therapy were compared with 100 age and sex-matched HIV-negative Ugandans; all were >45 years old with >1 cardiovascular disease risk factor. Subjects underwent ECG-gated non-contrast cardiac CT and transthoracic echocardiography with speckle tracking strain imaging. Multivariable linear and logistic regression models were used to explore the association of PCF with echocardiographic outcomes.ResultsMedian age was 55% and 62% were female. Compared with uninfected controls, PLHIV had lower body mass index (27 vs 30, p=0.02) and less diabetes (26% vs 45%, p=0.005). Median left ventricular (LV) ejection fraction was 67%. In models adjusted for traditional risk factors, HIV was associated with 10.3 g/m2 higher LV mass index (LVMI) (95% CI 3.22 to 17.4; p=0.005), 0.87% worse LV global longitudinal strain (GLS) (95% CI −1.66 to −0.07; p=0.03) and higher odds of diastolic dysfunction (OR 1.96; 95% CI 0.95 to 4.06; p=0.07). In adjusted models, PCF volume was significantly associated with increased LVMI and worse LV GLS, while PCF radiodensity was associated with worse LV GLS (all p<0.05).ConclusionsIn Uganda, HIV infection, PCF volume and density are associated with abnormal cardiac structure and function.

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Interrogating the haemodynamic effects of haemodialysis arteriovenous fistula on cardiac structure and function

Scientific Reports ◽

10.1038/s41598-021-97625-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sokratis Stoumpos ◽

Alastair Rankin ◽

Pauline Hall Barrientos ◽

Kenneth Mangion ◽

Ellon McGregor ◽

...

Keyword(s):

Cardiac Output ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Structure And Function ◽

Cardiac Structure ◽

Blood Flows ◽

Lv Mass ◽

Cardiac Structure And Function ◽

Lv Ejection Fraction ◽

And Function

AbstractArteriovenous fistula (AVF) is the preferred type of vascular access for maintenance haemodialysis but it may contribute to maladaptive cardiovascular remodelling. We studied the effect of AVF creation on cardiac structure and function in patients with chronic kidney disease (CKD). In this prospective cohort study patients with CKD listed for first AVF creation underwent cardiac magnetic resonance (CMR) imaging at baseline and at 6 weeks. All participants had ultrasound measurements of fistula blood flow at 6 weeks. The primary outcome was the change in left ventricular (LV) mass. Secondary outcomes included changes in LV volumes, LV ejection fraction, cardiac output, LV global longitudinal strain and N-terminal-pro B-type natriuretic peptide (NT-proBNP). A total of 55 participants were enrolled, of whom 40 (mean age 59 years) had AVF creation and completed both scans. On the second CMR scan, a mean increase of 7.4 g (95% CI 1.1–13.7, p = 0.02) was observed in LV mass. Significant increases in LV end-diastolic volumes (p = 0.04) and cardiac output (p = 0.02) were also seen after AVF creation. No significant changes were observed in LV end-systolic volumes, LV ejection fraction, NT-proBNP and LV global longitudinal strain. In participants with fistula blood flows ≥ 600 mL/min (n = 22) the mean increase in LV mass was 15.5 g (95% CI 7.3–23.8) compared with a small decrease of 2.5 g (95% CI − 10.6 to 5.6) in participants with blood flows < 600 mL/min (n = 18). Creation of AVF for haemodialysis resulted in a significant increase of LV myocardial mass within weeks after surgery, which was proportional to the fistula flow.

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Occupational Exposures and Cardiac Structure and Function: ECHO‐SOL (Echocardiographic Study of Latinos)

Journal of the American Heart Association ◽

10.1161/jaha.120.016122 ◽

2020 ◽

Vol 9 (17) ◽

Author(s):

Melissa S. Burroughs Peña ◽

Jean Claude Uwamungu ◽

Catherine M. Bulka ◽

Katrina Swett ◽

Krista M. Perreira ◽

...

Keyword(s):

Ejection Fraction ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Occupational Exposures ◽

Structure And Function ◽

Cardiac Structure ◽

Vehicle Exhaust ◽

Cardiac Structure And Function ◽

Lv Ejection Fraction ◽

And Function

Background Our objective was to determine associations of occupational exposures with cardiac structure and function in Hispanic/Latino adults. Methods and Results Employed participants were included (n=782; 52% women, mean age 52.9 years). Occupational exposures to burning wood, vehicle exhaust, solvents, pesticides, and metals at the current and longest‐held job were assessed by questionnaire. Survey multivariable linear regression analyses were used to model the relationship of each self‐reported exposure with echocardiographic measures of cardiac structure and function. Exposure to burning wood at the current job was associated with decreased left ventricular (LV) ejection fraction (−3.1%; standard error [SE], 1.0 [ P =0.002]). When the analysis was restricted to exposure at the longest‐held job, occupational exposure to burning wood was associated with increased LV diastolic volume (6.7 mL; SE, 1.6 [ P <0.0001]), decreased LV ejection fraction (−2.7%; SE, 0.6 [ P <0.0001]), worse LV global longitudinal strain (1.0%; SE, 0.3 [ P =0.0009]), and decreased right ventricular fractional area change (−0.02; SE, 0.004 [ P <0.001]). Exposure to pesticides was associated with worse average global longitudinal strain (0.8%; SE, 0.2 [ P <0.0001]). Exposure to metals was associated with worse global longitudinal strain in the 2‐chamber view (1.0%; SE, 0.5 [ P =0.04]), increased stroke volume (3.6 mL; SE, 1.6 [ P =0.03]), and increased LV mass indexed to BSA (9.2 g/m 2 ; SE, 3.8 [ P =0.01]) or height (4.4 g/m 2.7 ; SE, 1.9 [ P =0.02]). Conclusions Occupational exposures to burning wood, vehicle exhaust, pesticides, and metals were associated with abnormal parameters of LV and right ventricular systolic function. Reducing exposures to toxic chemicals and particulates in the workplace is a potential opportunity to prevent cardiovascular disease in populations at risk.

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Cardiac structure and function with and without metabolic syndrome: the Echocardiographic Study of Latinos (Echo-SOL)

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2017-000484 ◽

2018 ◽

Vol 6 (1) ◽

pp. e000484 ◽

Cited By ~ 1

Author(s):

Melissa Burroughs Peña ◽

Katrina Swett ◽

Neil Schneiderman ◽

Daniel M Spevack ◽

Sonia G Ponce ◽

...

Keyword(s):

Metabolic Syndrome ◽

Longitudinal Strain ◽

Left Ventricular ◽

Normal Weight ◽

Structure And Function ◽

Cardiac Structure ◽

Echocardiographic Study ◽

Confounding Variables ◽

Cardiac Structure And Function ◽

And Function

ObjectiveWe assessed the hypothesis that metabolic syndrome is associated with adverse changes in cardiac structure and function in participants of the Echocardiographic Study of Latinos (Echo-SOL).MethodsNon-diabetic Echo-SOL participants were included in this cross-sectional analysis. Metabolic syndrome was defined according to the American Heart Association/National Heart, Lung, and Blood Institute 2009 Joint Scientific Statement. Survey multivariable linear regression analyses using sampling weights were used adjusting for multiple potential confounding variables. Additional analysis was stratified according to the presence/absence of obesity (body mass index (BMI) ≥25 kg/m2) and the presence/absence of metabolic syndrome.ResultsWithin Echo-SOL, 1260 individuals met inclusion criteria (59% female; mean age 55.2 years). Compared with individuals without metabolic syndrome, those with metabolic syndrome had lower medial and lateral E′ velocities (−0.4 cm/s, (SE 0.1), p=0.0002; −0.5 cm/s (0.2), p=0.02, respectively), greater E/E′ (0.5(0.2), p=0.01) and worse two-chamber left ventricular longitudinal strain (0.9%(0.3), p=0.009), after adjusting for potential confounding variables. Increased left ventricular mass index (9.8 g/m2 (1.9), p<0.0001 and 7.5 g/m2 (1.7), p<0.0001), left ventricular end-diastolic volume (11.1 mL (3.0), p=0.0003 and 13.3 mL (2.7), p<0.0001), left ventricular end-systolic volume (5.0 mL (1.4), p=0.0004 and 5.7 mL (1.3) p<0.0001) and left ventricular stroke volume (10.2 mL (1.8), p<0.0001 and 13.0 mL (2.0), p<0.0001) were observed in obese individuals with and without metabolic syndrome compared with individuals with normal weight without metabolic syndrome. In sensitivity analyses, individuals with normal weight (BMI <25 kg/m2) and metabolic syndrome had worse left ventricular global longitudinal strain (2.1%(0.7), p=0.002) and reduced left ventricular ejection fraction (−3.5%(1.4), p=0.007) compared with normal-weight individuals without metabolic syndrome.ConclusionsIn a sample of US Hispanics/Latinos metabolic syndrome was associated with worse left ventricular systolic and diastolic function. Adverse changes in left ventricular size and function were observed in obese individuals with and without metabolic syndrome but decreased left ventricular function was also present in normal-weight individuals with metabolic syndrome.

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Interrogating the Haemodynamic Effects of Haemodialysis Arteriovenous Fistula on Cardiac Structure and Function

10.21203/rs.3.rs-603701/v1 ◽

2021 ◽

Author(s):

Sokratis Stoumpos ◽

Alastair Rankin ◽

Pauline Hall Barrientos ◽

Kenneth Mangion ◽

Ellon McGregor ◽

...

Keyword(s):

Cardiac Output ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Structure And Function ◽

Cardiac Structure ◽

Blood Flows ◽

Lv Mass ◽

Cardiac Structure And Function ◽

Lv Ejection Fraction ◽

And Function

Abstract Arteriovenous fistula (AVF) is the preferred type of vascular access for maintenance haemodialysis but it may contribute to maladaptive cardiovascular remodelling. We studied the effect of AVF creation on cardiac structure and function in patients with chronic kidney disease (CKD). In this prospective cohort study patients with CKD listed for first AVF creation underwent cardiac magnetic resonance (CMR) imaging at baseline and at 6 weeks. All participants had ultrasound measurements of fistula blood flow at 6 weeks. The primary outcome was the change in left ventricular (LV) mass. Secondary outcomes included changes in LV volumes, LV ejection fraction, cardiac output, LV global longitudinal strain and N-terminal-pro B-type natriuretic peptide (NT-proBNP). A total of 55 participants were enrolled, of whom 40 (mean age 59 years) had AVF creation and completed both scans. On the second CMR scan, a mean increase of 7.4g (95%CI, 1.1–13.7, p=0.02) was observed in LV mass. Significant increases in LV end-diastolic volumes (p=0.04) and cardiac output (p=0.02) were also seen after AVF creation. No significant changes were observed in LV end-systolic volumes, LV ejection fraction, NT-proBNP and LV global longitudinal strain. In participants with fistula blood flows ≥600mL/min (n=22) the mean increase in LV mass was 15.5g (95%CI, 7.3–23.8) compared with a small decrease of 2.5g (95%CI, −10.6 to 5.6) in participants with blood flows <600mL/min (n=18). Creation of AVF for haemodialysis resulted in a significant increase of LV myocardial mass within weeks after surgery, which was proportional to the fistula flow.

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Abstract 13131: Impact of Exercise Training on Cardiac Structure and Function in Patients With Type-2 Diabetes or Obesity: A Meta-analysis of Randomized Control Trials

Circulation ◽

10.1161/circ.132.suppl_3.13131 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Vidhu Anand ◽

Ambarish Pandey ◽

Sushil Kumar Garg

Keyword(s):

Exercise Training ◽

Diastolic Function ◽

Cardiorespiratory Fitness ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Structure And Function ◽

Cardiac Structure ◽

Diastolic Velocity ◽

Cardiac Structure And Function ◽

And Function

Background: Type 2 Diabetes mellitus (T2DM) and obesity are associated with subclinical abnormalities in left ventricular structure and function and an increased downstream risk for heart failure. Exercise training has been associated with significant improvement in cardiorespiratory fitness among these patients. However, its impact of cardiac structure and function is not well established. In this meta-analysis, we evaluated the effect of exercise training on the LV systolic and diastolic function in patients with T2DM or obesity. Methods: We included all randomized control trials (RCTs) that evaluated the effect of exercise training on cardiac structure and function among obese or T2DM patients. Primary outcome of interest was change in cardiorespiratory fitness (peak oxygen uptake, ml/kg/min) and measures of left ventricular systolic (global longitudinal strain) and diastolic function (early diastolic velocity, e`). Results: The study included 484 patients who were enrolled in 8 RCTs. In the pooled data analysis, patients with T2DM or obesity undergoing exercise training had significant improvements in peak oxygen uptake [Weighted Mean Difference (WMD): 1.30 (95%CI: 0.55 to 2.04)]. Among echocardiographic outcomes, exercise training participants had modest but statistically significant improvements in early diastolic velocity [WMD (95% CI): 0.46 (0.01 to 0.09)], and global longitudinal strain [WMD (95% CI): 0.62 (0.04 to 0.09)] as compared with control group participants (Figure). Conclusion: Exercise training in patients with T2DM or obesity is associated with a significant improvement in cardiorespiratory fitness and modest improvements in echocardiographic measures of systolic and diastolic function. These findings suggest that exercise training may improve subclinical systolic and diastolic dysfunction in patients at risk for HF in later life.

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The mitral regurgitation effects of cardiac structure and function in left ventricular noncompaction

Scientific Reports ◽

10.1038/s41598-021-84233-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Qing Zou ◽

Rong Xu ◽

Xiao Li ◽

Hua-yan Xu ◽

Zhi-gang Yang ◽

...

Keyword(s):

Mitral Regurgitation ◽

Nyha Class ◽

Left Ventricular ◽

Structure And Function ◽

Left Ventricular Geometry ◽

Cardiac Structure ◽

Left Ventricular Noncompaction ◽

Ventricular Noncompaction ◽

Cardiac Structure And Function ◽

And Function

AbstractThis study evaluated the effects of mitral regurgitation (MR) on cardiac structure and function in left ventricular noncompaction (LVNC) patients. The clinical and cardiovascular magnetic resonance (CMR) data for 182 patients with noncompaction or hypertrabeculation from three institutes were retrospectively included. We analyzed the difference in left ventricular geometry, cardiac function between LVNC patients with and without MR. The results showed that patients with MR had a worse New York Heart Association (NYHA) class and a higher incidence of arrhythmia (P < 0.05). MR occurred in 48.2% of LVNC patients. Compared to LVNC patients without MR, the two-dimensional sphericity index, maximum/minimum end-diastolic ratio and longitudinal shortening in LVNC patients with MR were lower (P < 0.05), and the peak longitudinal strain (PLS) of the global and segmental myocardium were obviously reduced (P < 0.05). No significant difference was found in strain in LVNC patients with different degree of MR; end diastolic volume, end systolic volume, and global PLS were statistically associated with MR and NYHA class (P < 0.05), but the non-compacted to compacted myocardium ratio had no significant correlation with them. In conclusion, the presence of MR is common in LVNC patients. LVNC patients with MR feature more severe morphological and functional changes. Hypertrabeculation is not an important factor affecting structure and function at the heart failure stage.

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Abstract 6278: Burden of Chronic Renal Insufficiency in the General Population and Added Predictive Power of GFR to BNP and NT-proBNP in Detection of Altered Ventricular Structure and Function

Circulation ◽

10.1161/circ.118.suppl_18.s_1173 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Alessandro Cataliotti ◽

Richard J Rodeheffer ◽

Douglas W Mahoney ◽

Carolyn S Lam ◽

Margaret M Redfield ◽

...

Keyword(s):

General Population ◽

Renal Insufficiency ◽

Chronic Renal Insufficiency ◽

Predictive Power ◽

Left Ventricular ◽

Structure And Function ◽

Cardiac Biomarkers ◽

Cardiac Structure ◽

Cardiac Structure And Function ◽

And Function

Background: Chronic renal insufficiency (CRI) is a strong predictor of increased mortality in the presence of heart failure (HF) and its prevalence has been increasing in the US. In addition, CRI is a major contributing factor to the progression of HF as it is associated with chronic volume overload, accelerated atherosclerosis and hypertension (HTN). The first aim of the current study was to evaluate the prevalence of CRI in an adult general population. The second aim was to address whether calculated glomerular filtration rate (cGFR) adds value to the cardiac biomarkers BNP and NT-proBNP in detecting early cardiac structural and functional impairments in the general population. Methods: From 1997 to 1999 medical history, physical examination, echocardiography, BNP (Biosite) and NT-proBNP (Roche) and serum creatinine (SCr) were obtained in 1,982 randomly selected residents of Olmsted County, MN >= 45 years (range 45 – 96 years). GFR was calculated using the Cockroft Gault equation. CRI was defined as a GFR < 60 ml/min. Cardiac structure and function were evaluated by in-depth echocardiographic examination. Results: The prevalence of cardiovascular co-morbidities was coronary atherosclerosis 12%, HTN 29.5% and diabetes mellitus 7.5%. The prevalence of CRI was 22.8% when cGFR was used for its detection. Importantly, by Chi-Square model, cGFR significantly increased the ability of BNP in detecting left ventricular hypertrophy (LVH) (p=0.004), increased relative wall thickness (p=0.0036), diastolic dysfunction (DDF) (p=0.0001) and HTN (p=0.0002). Similarly, when combined with NT-proBNP, cGFR increased the predictive power of detecting DDF (p=0.0001) and HTN (p=0.0366). Conclusion: This study reports a higher than predicted prevalence of CRI in this general US population equal to 23% and closely associated with the prevalence of HTN (29.5%). Importantly, this study also demonstrates that cGFR has additive predictive power when used in combination with two cardiac biomarkers of cardiac dysfunction and remodeling, BNP and NT-proBNP. These studies underscore the increasing burden of CRI in the general population and the utility of assessing cardiorenal function by combining renal and cardiac biomarkers in assessment of cardiac structure and function.

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Childhood and adult exposure to secondhand tobacco smoke and cardiac structure and function: results from Echo-SOL

Open Heart ◽

10.1136/openhrt-2018-000831 ◽

2018 ◽

Vol 5 (2) ◽

pp. e000831 ◽

Cited By ~ 2

Author(s):

Melissa Suzanne Burroughs Peña ◽

Katrina Swett ◽

Robert C Kaplan ◽

Krista Perreira ◽

Martha Daviglus ◽

...

Keyword(s):

Left Ventricular ◽

Structure And Function ◽

Cardiac Structure ◽

Isovolumic Relaxation Time ◽

Shs Exposure ◽

Cardiac Structure And Function ◽

And Function ◽

Relationship Of ◽

The Relationship ◽

Isovolumic Relaxation

ObjectiveTo describe the relationship of household secondhand smoke (SHS) exposure and cardiac structure and function.MethodsParticipants (n=1069; 68 % female; age 45–74 years) without history of tobacco use, coronary artery disease or severe valvular disease were included. Past childhood (starting at age <13 years), adolescent/adult and current exposure to household SHS was assessed. Survey linear regression analyses were used to model the relationship of SHS exposure and echocardiographic measures of cardiac structure and function, adjusting for covariates (age, sex, study site, alcohol use, physical activity and education).ResultsSHS exposure in childhood only was associated with reduced E/A velocity ratio (β=−0.06 (SE 0.02), p=0.008). SHS exposure in adolescence/adult only was associated with increased left ventricular ejection fraction (LVEF) (1.2 (0.6), p=0.04), left atrial volume index (1.7 (0.8), p=0.04) and decreased isovolumic relaxation time (−0.003 (0.002), p=0.03). SHS exposure in childhood and adolescence/adult was associated with worse left ventricular global longitudinal strain (LVGLS) (two-chamber) (0.8 (0.4), p= 0.049). Compared with individuals who do not live with a tobacco smoker, individuals who currently live with at least one tobacco smoker had reduced LVEF (−1.4 (0.6), p=0.02), LVGLS (average) (0.9 (0.40), p=0.03), medial E′ velocity (−0.5 (0.2), p=0.01), E/A ratio (−0.09 (0.03), p=0.003) and right ventricular fractional area change (−0.02 (0.01), p=0.01) with increased isovolumic relaxation time (0.006 (0.003), p=0.04).ConclusionsPast and current household exposure to SHS was associated with abnormalities in cardiac systolic and diastolic function. Reducing household SHS exposure may be an opportunity for cardiac dysfunction prevention to reduce the risk of future clinical heart failure.

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Association between Reduced estimated Glomerular Filtration Rate and Cardiac Structure and Function in Patients with Essential Hypertension

10.22541/au.163428484.43885905/v1 ◽

2021 ◽

Author(s):

Liying Mu ◽

Lu Chen ◽

juan du ◽

Hua Jiang ◽

Caixia Guo ◽

...

Keyword(s):

Essential Hypertension ◽

Left Atrial ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Left Ventricular ◽

Structure And Function ◽

Right Atrial ◽

Cardiac Structure ◽

Cardiac Structure And Function ◽

And Function

Objectives To investigate the relationship between small reductions in estimated glomerular filtration rate (eGFR) and cardiac structure and function in patients with essential hypertension. Methods The study group included 565 patients with essential hypertensive. eGFR was calculated by EPI equation and cardiac structure and function were assessed using echocardiography. The participants were divided into three groups: eGFR ≥90 mL/min /1.73 m2, 60-89 mL/min/1.73 m2, and 30-59 mL/min /1.73 m2. Pearson correlation analysis and multiple stepwise linear regression analysis were performed to evaluate associations between eGFR and echocardiogram parameters. Results Compared with patients with eGFR ≥ 90 mL/min/ 1.73 m2, those with eGFR 60-89 mL/min/ 1.73 m2 and 30-59 mL/min/ 1.73 m2 had higher left ventricular end-diastolic diameter (LVEDD) (p=0.019), mitral valve E wave (p=0.004), left atrial diameter (LAD) (p=0.001), right atrial diameter (RAD) (p=0.001), right ventricular diameter (RVD) (p=0.001) and lower left ventricular ejection fraction (LVEF) (p=0.01). After further adjustment for traditional cardiovascular risk factors including systolic and diastolic blood pressure, BMI, diabetes, dyslipidemia and smoking, eGFR was still associated with LVEF (p＜0.001), LAD (p＜0.001) and RAD (p=0.003). Conclusion Among patients with essential hypertension, even mildly reduced renal function is independently associated with greater cardiac remodeling, indicated by left atrial and right atrial enlargement, and worse left ventricular systolic function.

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