Renal resistive index and left ventricular mass index: A correlation study in hypertension

Siti Aulia Hidayat; Sitti Rabiul Zatalia Ramadhan; Pendrik Tendean; Syakib Bakri; Haerani  Rasyid; Hasyim Kasim; Akhyar Albaar; Nasrum Machmud; Khadijah Khairunnisa Hasyim; Achmad  Fikry; Arifin Seweng

doi:10.23750/abm.v96i1.16615

Renal resistive index and left ventricular mass index: A correlation study in hypertension

Authors

Siti Aulia Hidayat Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0009-0003-8139-6544
Sitti Rabiul Zatalia Ramadhan Nephrology and Hypertension Division, Department of Internal Medicine, Hasanuddin University, Makassar, Indonesia
Pendrik Tendean Cardiovascular Division, Department of Internal Medicine, Hasanuddin University, Makassar, Indonesia
Syakib Bakri Nephrology and Hypertension Division, Department of Internal Medicine, Hasanuddin University, Makassar, Indonesia
Haerani Rasyid Nephrology and Hypertension Division, Department of Internal Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0001-7404-2973
Hasyim Kasim Nephrology and Hypertension Division, Department of Internal Medicine, Hasanuddin University, Makassar, Indonesia
Akhyar Albaar Nephrology and Hypertension Division, Department of Internal Medicine, Hasanuddin University, Makassar, Indonesia
Nasrum Machmud Nephrology and Hypertension Division, Department of Internal Medicine, Hasanuddin University, Makassar, Indonesia
Khadijah Khairunnisa Hasyim Nephrology and Hypertension Division, Department of Internal Medicine, Hasanuddin University, Makassar, Indonesia
Ahmad Fikry Nephrology and Hypertension Division, Department of Internal Medicine, Hasanuddin University, Makassar, Indonesia
Arifin Seweng Department of Public Health and Community Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia

Keywords:

hypertension, Left Ventricular Mass Index, Renal Resistive Index, hypertensive patients, renal vascular resistance, left ventricular hypertrophy

Abstract

Background and aim: Hypertension causes damage to various organs such as the kidneys and heart. The effects of hypertension on the heart are often found in patients with Left Ventricular Hypertrophy (LVH) which can be measured by the Left Ventricular Mass Index (LVMI). The effects of hypertension on the kidneys can cause renal vascular resistance which can be measured by the Renal Resistive Index (RRI). This study aims to determine the correspondence between RRI and LVMI in hypertensive patients. Methods: This was an analytical observational study using a cross-sectional design by examining RRI and LVMI values in patients who have been diagnosed with hypertension at Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital from March 2024 to August 30, 2024. RRI measurements were taken using Intrarenal Artery Doppler USG, and LVMI measurements were taken using ultrasound. Data were analyzed using the chi-square test, Spearman correlation, and independent sample t-test. Results: A total of 54 hypertensive patients were collected, most of whom were > 60 years old (53.7%) and female (51.9%). LVMI had a significant relationship with RRI (p <, 001). There was a positive and moderate correlation between RRI and LVMI values (r = 0.480; p <0.001). RRI ≥ 0.7 was found to be significantly higher in LVH (100%) compared to non-LVH (0%) (p < 0.05). Conclusions: There was a correlation between the increase in RRI values and the increase in LVMI in hypertensive patients.

References

Mills KT, Bundy JD, Kelly TN, et al. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation. 2016;134(6):441-450. doi:10.1161/CIRCULATIONAHA.115.018912

Irianto I, Armyn AAU, Hijriansyah LOAH, Hermilasari H, Subair H. Studi In Vitro dan In Silico EfektivitasEkstrak Mentimun (Cucumis sativus) dalam Menurunkan Hipertensi. Nusant Med Sci J. 2021:61-70. doi:10.20956/nmsj.v5i2.8181

Stanaway JD, Afshin A, Gakidou E, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018;392(10159):1923-1994. doi:10.1016/S0140-6736(18)32225-6

Kementerian Kesehatan Republik Indonesia. Hasil Utama RISKESDAS 2018. Kementerian Kesehatan Republik Indonesia; 2018.

Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertens Dallas Tex 1979. 2020;75(6):1334-1357. doi:10.1161/HYPERTENSIONAHA.120.15026

Nadar SK, Lip GYH. The heart in hypertension. J Hum Hypertens. 2021;35(5):383-386. doi:10.1038/s41371-020-00427-x

Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr Off Publ Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi:10.1016/j.echo.2014.10.003

Sveceny J, Charvat J, Hrach K, Horackova M, Schuck O. In essential hypertension, a change in the renal resistive index is associated with a change in the ratio of 24-hour diastolic to systolic blood pressure. Physiol Res. 2022;71(3):341-348. doi:10.33549/physiolres.934860

Darabont R, Mihalcea D, Vinereanu D. Current Insights into the Significance of the Renal Resistive Index in Kidney and Cardiovascular Disease. Diagn Basel Switz. 2023;13(10):1687. doi:10.3390/diagnostics13101687

Granata A, Zanoli L, Clementi S, Fatuzzo P, Di Nicolò P, Fiorini F. Resistive intrarenal index: myth or reality? Br J Radiol. 2014;87(1038):20140004. doi:10.1259/bjr.20140004

Tedesco MA, Natale F, Mocerino R, Tassinario G, Calabrò R. Renal resistive index and cardiovascular organ damage in a large population of hypertensive patients. J Hum Hypertens. 2007;21(4):291-296. doi:10.1038/sj.jhh.1002145

Doi Y, Iwashima Y, Yoshihara F, et al. Association of renal resistive index with target organ damage in essential hypertension. Am J Hypertens. 2012;25(12):1292-1298. doi:10.1038/ajh.2012.113

Grebe SJ, Malzahn U, Donhauser J, et al. Quantification of left ventricular mass by echocardiography compared to cardiac magnet resonance imaging in hemodialysis patients. Cardiovasc Ultrasound. 2020;18(1):39. doi:10.1186/s12947-020-00217-y

Cilsal E, Koc AS. Renal resistive index significantly increased in hypertensive children and it is independently related to the pulse pressure and left ventricular mass index. Clin Exp Hypertens N Y N 1993. 2019;41(7):607-614. doi:10.1080/10641963.2018.1523920

Kuznetsova T, Cauwenberghs N, Knez J, et al. Doppler Indexes of Left Ventricular Systolic and Diastolic Flow and Central Pulse Pressure in Relation to Renal Resistive Index. Am J Hypertens. 2015;28(4):535-545. doi:10.1093/ajh/hpu185

Pontremoli R, Viazzi F, Martinoli C, et al. Increased renal resistive index in patients with essential hypertension: a marker of target organ damage. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc - Eur Ren Assoc. 1999;14(2):360-365. doi:10.1093/ndt/14.2.360

Viazzi F, Leoncini G, Derchi LE, Pontremoli R. Ultrasound Doppler renal resistive index: a useful tool for the management of the hypertensive patient. J Hypertens. 2014;32(1):149-153. doi:10.1097/HJH.0b013e328365b29c

Kotruchin P, Hoshide S, Ueno H, Shimizu H, Komori T, Kario K. Differential Impact of the Renal Resistive Index on Future Cardiovascular Events in Hospitalized Atherosclerotic Cardiovascular Patients According to Left Ventricular Ejection Fraction ― The Jichi Vascular Hemodynamics in Hospitalized Cardiovascular Patients (J-VAS) Study ―. Circ J. 2020;84(9):1544-1551. doi:10.1253/circj.CJ-19-1166

Manousopoulos K, Spiliopoulou S, Tsoutsoura N, Lykka A, Dimitriou A, Manios E. ASSOCIATION OF LEFT VENTRICULAR MASS INDEX WITH ALL-CAUSE MORTALITY IN CHRONIC KIDNEY DISEASE PATIENTS. J Hypertens. 2022;40(Suppl 1):e249-e250. doi:10.1097/01.hjh.0000838048.92680.b4

Heine GH, Gerhart MK, Ulrich C, Köhler H, Girndt M. Renal Doppler resistance indices are associated with systemic atherosclerosis in kidney transplant recipients. Kidney Int. 2005;68(2):878-885. doi:10.1111/j.1523-1755.2005.00470.x

Li Y, Wang JG, Dolan E, et al. Ambulatory arterial stiffness index derived from 24-hour ambulatory blood pressure monitoring. Hypertens Dallas Tex 1979. 2006;47(3):359-364. doi:10.1161/01.HYP.0000200695.34024.4c

Bots ML, Witteman JC, Hofman A, de Jong PT, Grobbee DE. Low diastolic blood pressure and atherosclerosis in elderly subjects. The Rotterdam study. Arch Intern Med. 1996;156(8):843-848.

Mimran A, Ribstein J, DuCailar G. Is microalbuminuria a marker of early intrarenal vascular dysfunction in essential hypertension? Hypertens Dallas Tex 1979. 1994;23(6 Pt 2):1018-1021. doi:10.1161/01.hyp.23.6.1018

Kahan T, Bergfeldt L. Left ventricular hypertrophy in hypertension: its arrhythmogenic potential. Heart Br Card Soc. 2005;91(2):250-256. doi:10.1136/hrt.2004.042473