Left ventricular dilatation and subclinical renal damage in primary hypertension

Ratto, Elena; Viazzi, Francesca; Bonino, Barbara; Gonnella, Annalisa; Garneri, Debora; Parodi, E; Bezante, Gian Paolo; Derchi, Lorenzo E.; Leoncini, Giovanna; Pontremoli, Roberto

doi:10.1097/hjh.0000000000000430

Cited by 12 publications

(9 citation statements)

References 31 publications

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“…In the present study, a positive correlation was found between LV dilatation, functions, and RRI. Ratto et al [26] also reported a correlation between LV dilatation, functions, and RRI. LV hypertrophy (eccentric and concentric hypertrophy) has been established to be an independent predictor of RRI in the present study.…”

Section: Discussionmentioning

confidence: 98%

Relationship between Aortic Arch Calcification, Detected by Chest X-Ray, and Renal Resistive Index in Patients with Hypertension

et al. 2018

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Objective: Aortic arch calcification (AAC) is a surrogate marker for arterial stiffness and hypertension-related vascular damage. Renal resistive index (RRI), a renal Doppler ultrasonography parameter, is used to assess renal hemodynamics. In this study, we aimed to evaluate the relationship between RRI and AAC in patients with hypertension. Methods: Patients with hypertension underwent a chest X-ray and re nal Doppler ultrasonography. They were divided into two groups according to RRI (group 1: RRI ≥0.70; group 2: RRI < 0.70). Two examiners, blinded to the findings of RRI, reviewed the AAC in these patients. The kappa value was detected to be 0.781 and a p value < 0.001 was considered significant. Results: The study included 289 hypertensive patients (mean age 63.87 ± 11.38 years). In 53.6% (n = 155) of the study subjects, RRI was observed to be ≥0.70. Patients with RRI ≥70 were older and had more prevalent AAC as well as left ventricular hypertrophy. A multiple linear regression analysis was carried out to test whether presence of AAC significantly predicted RRI. The results of the regression analysis indicated that presence of AAC significantly predicted RRI (β = 0.053; p < 0.001). Conclusions: A strong and independent relationship was found between AAC on chest X-ray and RRI in patients with hypertension.

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Section: Discussionmentioning

confidence: 98%

Relationship between Aortic Arch Calcification, Detected by Chest X-Ray, and Renal Resistive Index in Patients with Hypertension

et al. 2018

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“…Dilated LV geometries as identified by this new classification have been shown to be strongly related to the presence of microalbuminuria in a large group of hypertensive patients. 21 Furthermore, when this classification was applied to high-risk hypertensive patients enrolled in the LIFE trial, it revealed significant differences in haemodynamic patterns and LV function 22 and enhanced prediction of cardiovascular prognosis. 10 In fact, both dilated and Metabolic syndrome and left ventricular dilatation E Ratto et al concentric patterns were found to be associated with increased incidence of cardiovascular events, whereas the eccentric nondilated group was not.…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome is associated with left ventricular dilatation in primary hypertension

et al. 2015

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Metabolic syndrome (MS) has been shown to predict cardiovascular events in hypertension. Recently, a new four-group left ventricular (LV) hypertrophy classification based on both LV dilatation and concentricity was proposed. This classification has been shown to provide a more accurate prediction of cardiovascular events, suggesting that the presence of LV dilatation may add prognostic information. We investigated the relationship between MS and the new classification of LV geometry in patients with primary hypertension. A total of 372 untreated hypertensive patients were studied. Four different patterns of LV hypertrophy (eccentric nondilated, eccentric dilated, concentric nondilated and concentric dilated hypertrophy) were identified by echocardiography. A modified National Cholesterol Education Program definition for MS was used, with body mass index replacing waist circumference. The overall prevalence of MS and LV hypertrophy (LVH) was 29% and 61%, respectively. Patients with MS showed a higher prevalence of LVH (P=0.0281) and dilated LV geometries, namely eccentric dilated and concentric dilated hypertrophy (P=0.0075). Moreover, patients with MS showed higher LV end-diastolic volume (P=0.0005) and prevalence of increased LV end-diastolic volume (P=0.0068). The prevalence of LV chamber dilatation increased progressively with the number of components of MS (P=0.0191). Logistic regression analysis showed that the presence of MS entails a three times higher risk of having LV chamber dilatation even after adjusting for several potential confounding factors. MS is associated with LV dilatation in hypertension. These findings may, in part, explain the unfavourable prognosis observed in patients with MS.

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“…31 More interestingly, in the multivariate analysis arterial stiffness was an independent determinant of increased RRI, suggesting an independent association between renal hemodynamics and arterial stiffness. 33 This ratio of ultrasound determined renal volume to intra parenchymal resistive index has been proposed as a measure of nephroangiosclerosis and has been shown to be useful in identifying patients characterized by reduced kidney volume and increased renovascular stiffness. According to another recent study in 171 unselected subjects, RRI was significantly and independently associated with central pulse pressure and left ventricular systolic and diastolic Doppler blood flow indexes.…”

Section: Rri and Targ E T Org An Damag E In E Ss Ential Htnmentioning

confidence: 99%

“…32 In the same lines, in a total of 449 untreated hypertensives, left ventricular dilatation has been associated with subclinical renal damage, namely albuminuria and early intrarenal vascular changes, expressed as the renal volume to RRI ratio. 33 This ratio of ultrasound determined renal volume to intra parenchymal resistive index has been proposed as a measure of nephroangiosclerosis and has been shown to be useful in identifying patients characterized by reduced kidney volume and increased renovascular stiffness. 33…”

Section: Rri and Targ E T Org An Damag E In E Ss Ential Htnmentioning

confidence: 99%

Renal resistive index in hypertensive patients

Andrikou

Tsioufis

Konstantinidis

et al. 2018

J of Clinical Hypertension

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Spectral Doppler ultrasonography provides the evaluation of renal resistive index (RRI), a noninvasive and reproducible measure to investigate arterial compliance and/or resistance. RRI seems to possess an important role in the evaluation of diverse cases of secondary hypertension. In essential hypertension, RRI is associated with subclinical markers of target organ damage and reflects renal disease progression beyond albuminuria and creatinine clearance. Also, RRI can estimate cardiovascular and renal risk. The evaluation of RRI may also help the therapeutic decisions. Given its simple assessment, RRI emerges as a simple method and a “multifunctional” tool that could help on the cardiovascular risk evaluation of the hypertensive patient.

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Left ventricular dilatation and subclinical renal damage in primary hypertension

Abstract: Left ventricular dilatation is associated with subclinical renal damage in hypertension. These findings extend previous reports and provide a pathophysiological rationale for the observed unfavourable prognosis in patients with left ventricular dilatation.

Cited by 12 publications

References 31 publications

Relationship between Aortic Arch Calcification, Detected by Chest X-Ray, and Renal Resistive Index in Patients with Hypertension

Relationship between Aortic Arch Calcification, Detected by Chest X-Ray, and Renal Resistive Index in Patients with Hypertension

Metabolic syndrome is associated with left ventricular dilatation in primary hypertension

Renal resistive index in hypertensive patients

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