Relationship Between Renal Function, Aortic Stiffness and Left Ventricular Function in Patients With Coronary Artery Disease

Background: There are plausible reasons to hypothesize that increased aortic stiffness and left ventricular (LV) dysfunction may occur in early renal insufficiency. Methods and Results: The correlation of glomerular filtration rate (GFR) with the augmentation index (AI) of ascending aortic pressure and indices of LV systolic and diastolic function (ejection fraction, LV pressure relaxation time constant, LV end-diastolic pressure and mitral inflow (E/A) and annular velocities (S’ and E’)) was examined in 359 consecutive patients undergoing cardiac catheterization for coronary artery disease (CAD). When patients were stratified according to GFR of 60, 75 and 90 ml · min–1 · 1.73 m –2 , there was a progressive increase in AI and decreases in E/A and E’ with decreasing GFR. There were no linear trends in other indices of systolic or diastolic function across GFR groups. After adjustment for potential confounders, reduced GFR was associated with increased AI, but not with decreased E/A or E’. Conclusions: Early renal impairment may be partly associated with increased aortic stiffness, but not with LV systolic or diastolic function in CAD patients. (Circ J 2009; 73: 1740 – 1745)