Introduction: In patients with arterial hypertension andchronic kidney disease (CKD), the prevalence of diastolicheart failure (HF-PEF) is probably very high. However, inthese patients the diagnosis is difficult, especially becausethe signs and symptoms suggestive of HF-PEF are verycommon in CKD; in these cases the detection of left ventricularstructural and functional alterations (as reported inthe 2012 ESC guidelines on heart failure), assumes adecisive role for the diagnosis of HF-PEF.Aim: To evaluate the prevalence of patients with diastolicdysfunction according to ESC guidelines 2012 in a populationof Hypertensive patients with CKD.Methods: We studied 466 hypertensive patients with meanage of 62.3 ± 12.6 years (M/F = 262/204) suffering fromchronic kidney disease (stages 3-4-5 KDIGO), with a meanvalue of GFR equal to 26.8 ± 15.1 mL/min/1.73 m2. Thecriteria for exclusion from the study were: EF\50 %, othercardiovascular diseases that could cause heart failure. Wereconsidered with diastolic dysfunction, all patients with avalue of Em (evaluated with tissue Doppler imaging atlateral mitral annulus) less than 10 cm/s.Results: We found a value of Em \10 cm/s in 331/466patients (71 %). In order to determine the role of CKD toexplain the very high prevalence of diastolic dysfunction,we selected 160 hypertensive patients with overlappingfeatures to the previous group with regard to age, sex, BMI,etc. In this population the prevalence of diastolic dysfunctionwas 43.7 %.Conclusions: Our findings demonstrate a very high prevalenceof diastolic dysfunction in the studied population; itis possible to assume that a large proportion of thesepatients had HF-PEF or is at high risk for its development.The finding of a lower prevalence of diastolic dysfunctionin a hypertensive population supports the hypothesis of adecisive role of CKD in determining diastolic dysfunctionand HF-PEF.
|Numero di pagine||1|
|Stato di pubblicazione||Published - 2013|