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DEPRESSED CARDIAC MECHANICS IN HYPERTENSIVE PATIENTS WITH MODERATE CHRONIC RENAL INSUFFICIENCY: A SPECKLE-STRAIN STUDY: PP.9.346

Background: Systolic dysfunction in hypertension (HTN) and chronic kidney disease (CKD) is related to left ventricular (LV) hypertrophy. However, it has been suggested that in CKD interstitial collagen deposition is higher than in HTN, possibly further impairing systolic function. Accordingly, the aim of the present study was to compare echocardiographic speckle tracking strain (ϵ) in hypertensive patients with or without CKD. Methods: Standard Doppler echocardiography was obtained in 11 hypertensive patients with moderate CKD (stage III, GFR = 36 ± 12 mL/min/1.73 m2) and 22 age matched HTN (mean age 58 ± 14yrs) with normal renal function. Patients with significant valvular disease and/or reduced ejection fraction were excluded. Traditional assessment of LV systolic function included ejection fraction, and fractional and midwall shortening. Speckle tracking ϵ was evaluated in all three planes (circumferential, longitudinal, and radial). Results: CKD patients showed similar body mass index, systolic and diastolic blood pressure as compared to HTN (P = NS). LV mass index was similar in the HTN (49 g/m2.7) and the CKD group (50 g/m2.7) as well as relative wall thickness (0.48 vs 0.50; all p = NS). Traditional indices of systolic function were unable to discriminate between the two groups. In contrast, analysis of ϵ demonstrated a significant reduction in both circumferential and longitudinal ϵ in the CKD group (Figure). Figure 1. No caption available. Conclusions: Despite similar LV geometry and traditional systolic function indices, analysis of ϵ demonstrates impairment of cardiac mechanics in CKD, possibly caused by the presence of more severe myocardial fibrosis. Analysis of cardiac mechanics by speckle tracking echocardiography might be more sensitive in the assessment of CV risk in hypertensive CKD patients.