PURPOSE To evaluate the abnormal myocardial function in HFpEF patients with renal dysfunction and investigate the relationship between renal function and myocardial mechanical characteristics in patients with HFpEF. METHODS 134 patients with HFpEF and 32 control subjects were enrolled in our study. Clinical and echocardiography data were collected for offline analysis. Global work index(GWI), global constructive work(GCW), global waste work(GWW), and global work efficiency(GWE) were measured after non-invasive pressure strain loop analysis. Univariate and multivariate analyses were used to determine the correlation between renal function and myocardial function in patients with HFpEF. RESULTS In comparison to control subjects, patients with HFpEF tend to have higher GWW(78[50-115] vs 108[65-160] mmHg%, P<0.05) and lower GWE(96[95-97] vs 95[92-96] %, P<0.05) while LVEF(65.5±3.3 vs 64.3±4.6 %, P<0.05) were comparable between them. Besides, increased GWW(86[58-152] vs 125[94-187] mmHg%, P<0.05) and decreased GWE(96[93-97] vs 94[92-96] %, P<0.05) were detected in patients with renal dysfunction compared to those with normal renal function. An independent correlation was found between eGFR and GWW after multivariate analysis. CONCLUSIONS The more severely impaired myocardial function was detected in HFpEF patients with renal dysfunction compared to those with normal renal function. eGFR was independently correlated to GWW in patients with HFpEF.

中文翻译：

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射血分数保留的心力衰竭患者肾功能受损与亚临床心肌功能障碍之间的关联：使用无创压力应变环进行评估。

目的评价肾功能不全的HFpEF患者心肌功能异常情况，探讨HFpEF患者肾功能与心肌力学特征的关系。方法 134 名 HFpEF 患者和 32 名对照受试者参加了我们的研究。收集临床和超声心动图数据用于离线分析。经过非侵入性压力应变环分析后，测量了总体工作指数（GWI）、总体建设性工作（GCW）、总体废物工作（GWW）和总体工作效率（GWE）。采用单变量和多变量分析来确定 HFpEF 患者肾功能和心肌功能之间的相关性。结果 与对照受试者相比，HFpEF 患者往往具有较高的 GWW（78[50-115] vs 108[65-160] mmHg%，P<0.05）和较低的 GWE（96[95-97] vs 95[92] -96]％，P<0.05），而LVEF（65.5±3.3 vs 64.3±4.6％，P<0.05）之间具有可比性。此外，检测到 GWW 增加（86[58-152] vs 125[94-187] mmHg%，P<0.05）和 GWE 减少（96[93-97] vs 94[92-96]%，P<0.05）肾功能不全患者与肾功能正常患者相比。多变量分析后发现 eGFR 与 GWW 之间存在独立相关性。结论 与肾功能正常的患者相比，肾功能不全的 HFpEF 患者心肌功能受损更严重。HFpEF 患者的 eGFR 与 GWW 独立相关。