Journal
SCIENTIFIC REPORTS
Volume 10, Issue 1, Pages -Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41598-020-79351-6
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Funding
- Japan Society for the Promotion of Science [20K07828]
- Grants-in-Aid for Scientific Research [20K07828] Funding Source: KAKEN
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We aimed to clarify clinical implications of intrarenal hemodynamics assessed by intrarenal Doppler ultrasonography (IRD) and their prognostic impacts in heart failure (HF). We performed a prospective observational study, and examined IRD and measured interlobar renal artery velocity time integral (VTI) and intrarenal venous flow (IRVF) patterns (monophasic or non-monophasic pattern) to assess intrarenal hypoperfusion and congestion in HF patients (n=341). Seven patients were excluded in VTI analysis due to unclear imaging. The patients were divided into groups based on (A) VTI: high VTI (VTI >= 14.0 cm, n=231) or low VTI (VTI<14.0 cm, n=103); and (B) IRVF patterns: monophasic (n=36) or non-monophasic (n=305). We compared post-discharge cardiac event rate between the groups, and right-heart catheterization was performed in 166 patients. Cardiac index was lower in low VTI than in high VTI (P=0.04), and right atrial pressure was higher in monophasic than in non-monophasic (P=0.03). In the Kaplan-Meier analysis, cardiac event rate was higher in low VTI and monophasic groups (P<0.01, respectively). In the Cox proportional hazard analysis, the combination of low VTI and a monophasic IRVF pattern was a predictor of cardiac events (P<0.01). IRD imaging might be associated with cardiac output and right atrial pressure, and prognosis.
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