Scientific Reports (Dec 2020)

Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure

  • Akiomi Yoshihisa,
  • Koichiro Watanabe,
  • Yu Sato,
  • Shinji Ishibashi,
  • Mitsuko Matsuda,
  • Yukio Yamadera,
  • Yasuhiro Ichijo,
  • Tetsuro Yokokawa,
  • Tomofumi Misaka,
  • Masayoshi Oikawa,
  • Atsushi Kobayashi,
  • Yasuchika Takeishi

DOI
https://doi.org/10.1038/s41598-020-79351-6
Journal volume & issue
Vol. 10, no. 1
pp. 1 – 9

Abstract

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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.