Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure.
Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure.
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肾内多普勒超声检查反映了心力衰竭患者的血液动力学并预测预后。
DOI：
10.1038/s41598-020-79351-6
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发表时间：
2020-12-17
影响因子：
4.6
通讯作者：
Takeishi Y
中科院分区：
文献类型：
--
作者：
Yoshihisa A;Watanabe K;Sato Y;Ishibashi S;Matsuda M;Yamadera Y;Ichijo Y;Yokokawa T;Misaka T;Oikawa M;Kobayashi A;Takeishi Y
我们的目的是阐明肾内多普勒超声（IRD）评估肾内血流动力学的临床意义及其对心力衰竭（HF）预后的影响。我们进行了一项前瞻性观察性研究，并检查了IRD，测量了叶间肾动脉速度时间积分（VTI）和肾内静脉血流（IRVF）模式（单相或非单相模式），以评估HF患者（n = 341）的肾内灌注不足和充血。7例患者因影像不清晰而被排除在VTI分析之外。根据（A）VTI分为高VTI组（VTI ≥ 14.0 cm，n = 231）和低VTI组（VTI < 14.0 cm，n = 103）;（B）IRVF类型分为双相型组（n = 36）和非双相型组（n = 305）。我们比较了两组患者出院后心脏事件的发生率，并对166例患者进行了右心导管检查。低VTI组心脏指数低于高VTI组（P = 0.04），同相组右房压高于非同相组（P = 0.03）。Kaplan-Meier分析显示，低VTI组和单相组心脏事件发生率较高（分别为P < 0.01）。在考克斯比例风险分析中，低VTI和单相IRVF模式的组合是心脏事件的预测因子（P < 0.01）。IRD显像与心输出量、右房压及预后有关。
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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影响因子：
18.2
作者：
Mohamed, Belal A.;Schnelle, Moritz;Khadjeh, Sara;Lbik, Dawid;Herwig, Melissa;Linke, Wolfgang A.;Hasenfuss, Gerd;Toischer, Karl
通讯作者：
Toischer, Karl
影响因子：
39.3
作者：
Ronco C;McCullough P;Anker SD;Anand I;Aspromonte N;Bagshaw SM;Bellomo R;Berl T;Bobek I;Cruz DN;Daliento L;Davenport A;Haapio M;Hillege H;House AA;Katz N;Maisel A;Mankad S;Zanco P;Mebazaa A;Palazzuoli A;Ronco F;Shaw A;Sheinfeld G;Soni S;Vescovo G;Zamperetti N;Ponikowski P;Acute Dialysis Quality Initiative (ADQI) consensus group
通讯作者：
Acute Dialysis Quality Initiative (ADQI) consensus group
影响因子：
20.1
作者：
Sharma K;Kass DA
通讯作者：
Kass DA
影响因子：
3.2
作者：
Horita, Y;Yakabe, K;Taura, K
通讯作者：
Taura, K
影响因子：
24
作者：
Damman, Kevin;van Deursen, Vincent M.;Hillege, Hans L.
通讯作者：
Hillege, Hans L.