Association between Left Ventricular Diastolic Dysfunction and Renal Hemodynamic Change in Patients with Treated Essential Hypertension

DOI PubMed 被引用文献1件 参考文献67件
  • OGATA Chinami
    Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center
  • HORIO Takeshi
    Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center
  • KAMIDE Kei
    Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center
  • TAKIUCHI Shin
    Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center
  • KAWANO Yuhei
    Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center

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The heart and kidneys are important target organs in hypertension. Early signs of hypertensive target organ damage can be detected by evaluating left ventricular (LV) diastolic function and intrarenal hemodynamics using Doppler ultrasonography. However, it has not been sufficiently clarified whether cardiac damage and renal impairment progress in parallel, especially from the early stage. In the present study, Doppler echocardiography and renal Doppler ultrasonography were performed in 99 patients with treated essential hypertension, and LV diastolic filling parameters, i.e., the velocity ratio of atrial filling to early diastolic filling (A/E), and the deceleration time of the E wave (DcT) and renal Doppler parameters, i.e., the diastolic to systolic ratio (D/S) and resistance index (RI), were determined. D/S was negatively correlated and RI was positively correlated with A/E and DcT. These cardiac and renal Doppler parameters were also associated with age, diastolic blood pressure, creatinine clearance, and/or glucose levels. By multiple regression analysis, D/S was found to have a significant association with DcT, independent of other clinical parameters, including age. In subgroup analysis in which patients were divided by their glucose tolerance, a significant correlation between renal Doppler parameters and LV diastolic function was observed in subjects with normal glucose tolerance, but this correlation disappeared in those with impaired glucose tolerance and diabetes mellitus. The present findings show that there is a significant relation between LV diastolic function and renal Doppler parameters in treated hypertensive patients, and suggest that cardiac damage progresses in parallel with renal involvement in these patients from the early stage. (Hypertens Res 2003; 26: 971-978)

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