Gori, M. et al. (2014) Association between renal function and cardiovascular structure and function in heart failure with preserved ejection fraction. European Heart Journal, 35(48), pp. 3442-3451. (doi: 10.1093/eurheartj/ehu254) (PMID:24980489)
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Abstract
Aim Renal dysfunction is a common comorbidity in patients with heart failure and preserved ejection fraction (HFpEF). We sought to determine whether renal dysfunction was associated with measures of cardiovascular structure/function in patients with HFpEF.<p></p> Methods We studied 217 participants from the PARAMOUNT study with HFpEF who had echocardiography and measures of kidney function. We evaluated the relationships between renal dysfunction [estimated glomerular filtration rate (eGFR) 30 and <60 mL/min/1.73 m2 and/or albuminuria] and cardiovascular structure/function.<p></p> Results The mean age of the study population was 71 years, 55% were women, 94% hypertensive, and 40% diabetic. Impairment of at least one parameter of kidney function was present in 62% of patients (16% only albuminuria, 23% only low eGFR, 23% both). Renal dysfunction was associated with abnormal LV geometry (defined as concentric hypertrophy, or eccentric hypertrophy, or concentric remodelling) (adjusted P = 0.048), lower midwall fractional shortening (MWFS) (P = 0.009), and higher NT-proBNP (P = 0.006). Compared with patients without renal dysfunction, those with low eGFR and no albuminuria had a higher prevalence of abnormal LV geometry (P = 0.032) and lower MWFS (P < 0.01), as opposed to those with only albuminuria. Conversely, albuminuria alone was associated with greater LV dimensions (P < 0.05). Patients with combined renal impairment had mixed abnormalities (higher LV wall thicknesses, NT-proBNP; lower MWFS).<p></p> Conclusion Renal dysfunction, as determined by both eGFR and albuminuria, is highly prevalent in HFpEF, and associated with cardiac remodelling and subtle systolic dysfunction. The observed differences in cardiac structure/function between each type of renal damage suggest that both parameters of kidney function might play a distinct role in HFpEF.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | McMurray, Professor John |
Authors: | Gori, M., Senni, M., Gupta, D.K., Charytan, D.M., Kraigher-Krainer, E., Pieske, B., Claggett, B., Shah, A.M., Santos, A.B.S., Zile, M.R., Voors, A.A., McMurray, J.J.V., Packer, M., Bransford, T., Lefkowitz, M., and Solomon, S.D. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
Journal Name: | European Heart Journal |
Journal Abbr.: | Eur. heart j. |
Publisher: | Oxford University Press |
ISSN: | 0195-668X |
ISSN (Online): | 1522-9645 |
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