Left Ventricular Structure, Geometry and Systolic Function among Hypertensive Black Patients with Reduced Kidney Function

Objective: To assess the LV mass, geometry and systolic function in hypertensive patients with reduced kidney function. Methods: According to ASE guidelines, we estimated LV ventricular mass, geometry and systolic function in 155 consecutive hypertensive patients [51% women, mean age 51 ± 12 years, median duration of hypertension 7 years] with reduced kidney function (eGFR 2 or dipstick proteinuria ≥ 1+). LVH was defined as LVMI >125 g/m2 in men, >110 g/m2 in non obese women or >51 g/m2.7 for obese men or women. Where appropriate, we used Student t, Mann Whitney, one way ANOVA or Chi square tests. A P value of 0.05 or less was considered significant. Results: Seventy four patients in the series (48%) had reduced kidney function (eGFR 30 ± 15 ml/min/1.73 m2). Compared to patients with relatively normal kidney function, non obese and obese patients with reduced kidney function had significantly greater LVM [271 (198 - 348) vs 276 (175 - 284) g/m2, p = 0.008] for non obese; LVM 72 (47 - 88) vs 54 (44 - 73) g/m2.7, p = 0.007 for obese] and lower EF (60 ± 14 vs 68 ± 13%, p < 0.001) was significantly lower. LVH of mainly concentric geometric pattern was present in 68 patients with reduced kidney function (92%). Conclusion: In the present case series, reduced kidney function was associated with increased LVM, concentric geometric pattern and impaired systolic function.