Supplementary Material for: Association between impaired renal function and subclinical myocardial dysfunction in patients with heart failure with preserved ejection fraction: assessment using noninvasive pressure-strain loop

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.