Value of Renal Vascular Doppler Sonography in Cardiorenal Syndrome Type 1.

Autor: Çakal B; Department of Cardiology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey., Özcan ÖU; Department of Cardiology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey., Omaygenç MO; Department of Cardiology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey., Karaca İO; Department of Cardiology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey., Kızılırmak F; Department of Cardiology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey., Gunes HM; Department of Cardiology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey., Boztosun B; Department of Cardiology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine [J Ultrasound Med] 2021 Feb; Vol. 40 (2), pp. 321-330. Date of Electronic Publication: 2020 Jul 23.
DOI: 10.1002/jum.15404
Abstrakt: Objectives: Worsening of renal function in a patient with acute decompensated heart failure is called cardiorenal syndrome (CRS) type 1. Recent studies have shown an association of persistent systemic venous congestion with renal dysfunction. This trial was set up to investigate the changes of renal Doppler parameters with diuretic therapy in patients with CRS type 1.
Methods: Cases of CRS type 1 were identified among patients hospitalized for decompensated heart failure. Serial measurements of the renal venous impedance index (VII) and arterial resistive index (ARI) were calculated by pulsed wave Doppler sonography.
Results: A total of 30 patients who had creatinine improvement with diuresis (group 1) and 34 patients without any improvement (group 2) were analyzed. Patients in group 1 had higher median VII and ARI (VII, 0.86 versus 0.66; P < .001; ARI, 0.78 versus 0.65; P < .001) on admission. A high ARI on admission (odds ratio, 6.25; 95% confidence interval, 1.84-14.3; P = .003) predicted the improvement of serum creatinine levels with diuretic therapy independent of confounding factors in patients with CRS type 1.
Conclusions: Renal vascular Doppler parameters might offer guidance on the diagnostic and therapeutic strategies in prescribing decongestive therapy for decompensated heart failure.
(© 2020 American Institute of Ultrasound in Medicine.)
Databáze: MEDLINE
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