Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure
Abstract 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 i...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2020-12-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-020-79351-6 |
| _version_ | 1818855457435942912 |
|---|---|
| author | Akiomi Yoshihisa Koichiro Watanabe Yu Sato Shinji Ishibashi Mitsuko Matsuda Yukio Yamadera Yasuhiro Ichijo Tetsuro Yokokawa Tomofumi Misaka Masayoshi Oikawa Atsushi Kobayashi Yasuchika Takeishi |
| author_facet | Akiomi Yoshihisa Koichiro Watanabe Yu Sato Shinji Ishibashi Mitsuko Matsuda Yukio Yamadera Yasuhiro Ichijo Tetsuro Yokokawa Tomofumi Misaka Masayoshi Oikawa Atsushi Kobayashi Yasuchika Takeishi |
| author_sort | Akiomi Yoshihisa |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-19T08:08:54Z |
| format | Article |
| id | doaj.art-52c643f443154d55b3b622d5e8bc7fa1 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-19T08:08:54Z |
| publishDate | 2020-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-52c643f443154d55b3b622d5e8bc7fa12022-12-21T20:29:41ZengNature PortfolioScientific Reports2045-23222020-12-011011910.1038/s41598-020-79351-6Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failureAkiomi Yoshihisa0Koichiro Watanabe1Yu Sato2Shinji Ishibashi3Mitsuko Matsuda4Yukio Yamadera5Yasuhiro Ichijo6Tetsuro Yokokawa7Tomofumi Misaka8Masayoshi Oikawa9Atsushi Kobayashi10Yasuchika Takeishi11Department of Cardiovascular Medicine, Fukushima Medical UniversityDepartment of Cardiovascular Medicine, Fukushima Medical UniversityDepartment of Cardiovascular Medicine, Fukushima Medical UniversityDepartment of Clinical Laboratory Medicine, Fukushima Medical UniversityDepartment of Clinical Laboratory Medicine, Fukushima Medical UniversityDepartment of Clinical Laboratory Medicine, Fukushima Medical UniversityDepartment of Cardiovascular Medicine, Fukushima Medical UniversityDepartment of Cardiovascular Medicine, Fukushima Medical UniversityDepartment of Cardiovascular Medicine, Fukushima Medical UniversityDepartment of Cardiovascular Medicine, Fukushima Medical UniversityDepartment of Cardiovascular Medicine, Fukushima Medical UniversityDepartment of Cardiovascular Medicine, Fukushima Medical UniversityAbstract 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.https://doi.org/10.1038/s41598-020-79351-6 |
| spellingShingle | Akiomi Yoshihisa Koichiro Watanabe Yu Sato Shinji Ishibashi Mitsuko Matsuda Yukio Yamadera Yasuhiro Ichijo Tetsuro Yokokawa Tomofumi Misaka Masayoshi Oikawa Atsushi Kobayashi Yasuchika Takeishi Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure Scientific Reports |
| title | Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure |
| title_full | Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure |
| title_fullStr | Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure |
| title_full_unstemmed | Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure |
| title_short | Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure |
| title_sort | intrarenal doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure |
| url | https://doi.org/10.1038/s41598-020-79351-6 |
| work_keys_str_mv | AT akiomiyoshihisa intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT koichirowatanabe intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT yusato intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT shinjiishibashi intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT mitsukomatsuda intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT yukioyamadera intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT yasuhiroichijo intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT tetsuroyokokawa intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT tomofumimisaka intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT masayoshioikawa intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT atsushikobayashi intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure AT yasuchikatakeishi intrarenaldopplerultrasonographyreflectshemodynamicsandpredictsprognosisinpatientswithheartfailure |