Introduction: In patients with arterial hypertension and
chronic kidney disease (CKD), the prevalence of diastolic
heart failure (HF-PEF) is probably very high. However, in
these patients the diagnosis is difficult, especially because
the signs and symptoms suggestive of HF-PEF are very
common in CKD; in these cases the detection of left ventricular
structural and functional alterations (as reported in
the 2012 ESC guidelines on heart failure), assumes a
decisive role for the diagnosis of HF-PEF.
Aim: To evaluate the prevalence of patients with diastolic
dysfunction according to ESC guidelines 2012 in a population
of Hypertensive patients with CKD.
Methods: We studied 466 hypertensive patients with mean
age of 62.3 ± 12.6 years (M/F = 262/204) suffering from
chronic kidney disease (stages 3-4-5 KDIGO), with a mean
value of GFR equal to 26.8 ± 15.1 mL/min/1.73 m2. The
criteria for exclusion from the study were: EF\50 %, other
cardiovascular diseases that could cause heart failure. Were
considered with diastolic dysfunction, all patients with a
value of Em (evaluated with tissue Doppler imaging at
lateral mitral annulus) less than 10 cm/s.
Results: We found a value of Em \10 cm/s in 331/466
patients (71 %). In order to determine the role of CKD to
explain the very high prevalence of diastolic dysfunction,
we selected 160 hypertensive patients with overlapping
features to the previous group with regard to age, sex, BMI,
etc. In this population the prevalence of diastolic dysfunction
was 43.7 %.
Conclusions: Our findings demonstrate a very high prevalence
of diastolic dysfunction in the studied population; it
is possible to assume that a large proportion of these
patients had HF-PEF or is at high risk for its development.
The finding of a lower prevalence of diastolic dysfunction
in a hypertensive population supports the hypothesis of a
decisive role of CKD in determining diastolic dysfunction
and HF-PEF