INTRARENAL HEMODYNAMICS IN ARTERIAL HYPERTENSION AND HEART FAILURE WITH PRESERVED EJECTION FRACTION
Keywords:intrarenal hemodynamics, heart failure with preserved ejection fraction, arterial hypertension
Objectives. Traditional cardiovascular risk factors, in the general population, are usually correlated with the prognosis, in patients with heart failure with preserved ejection fraction. The aim of the study was to assess the implications of intrarenal hemodynamics in heart failure with preserved ejection fraction.
Material and Methods. The research included 60 patients with heart failure with preserved ejection fraction, aged 18-79 years. All subjects underwent the following physical examination: 24-hours ambulatory blood pressure and electrocardiography monitoring, echocardiography, intrarenal Doppler ultrasound, obtaining the following parameters of the intrarenal hemodynamics: renal resistive index, renal pulsatile index, acceleration time.
Results. The analysis of blood pressure values showed that 22% (13 patients) had stage I arterial hypertension, 48% (29 patients) – stage II arterial hypertension and 30% (18 patients) – stage III arterial hypertension, while the mean age of arterial hypertension onset was 40,55 ± 10,27 years, the mean arterial hypertension duration being 9,57 ± 7,12 years, mean ejection fraction – 56 ± 4,562%, mean natriuretic peptide levels – 654 ± 93 pg/ml. There was a positive association of renal resistive index with ambulatory 24 hours systolic blood pressure (r=0,359, p < 0,01), mean daytime systolic blood pressure (r=0,260, p<0,05) ambulatory pulse pressure (r=0,266, p < 0,01), age (r=0,253, p< 0,01), left ventricular mass (r=0,459, p < 0,001) and relative wall thickness (r=0,293 p<0,01).
Conclusions. In addition to local renal vascular properties, the central hemodynamic factors significantly influence the intrarenal hemodynamics in heart failure with preserved ejection fraction. intrarenal hemodynamics is the result of a complex interaction between renal and systemic vascular factors useful in assessment of a large spectrum of cardiovascular conditions.
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