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The renal arterial resistance index: a marker of renal function with an independent and incremental role in predicting heart failure progression.
- Source :
-
European journal of heart failure [Eur J Heart Fail] 2014 Feb; Vol. 16 (2), pp. 210-6. Date of Electronic Publication: 2013 Dec 11. - Publication Year :
- 2014
-
Abstract
- Aims: The renal arterial resistance index (RRI) is a measure of renal blood flow obtained by Doppler ultrasonography, which has been demonstrated to reflect both vascular and parenchymal renal abnormalities. The aim of the study was to evaluate clinical correlates and the prognostic relevance of RRI in a group of patients affected by chronic heart failure (CHF).<br />Methods and Results: We enrolled 250 CHF outpatients in a stable clinical condition and receiving conventional therapy. Peak systolic velocity and end-diastolic velocity of a segmental renal artery were obtained by pulsed Doppler flow. Then the RRI was calculated. Standard renal function assessment was obtained by the measurement of creatinine serum levels and the estimation of the glomerular filtration rate (GFR). During follow-up (21.4 ± 11.3 months), 41 patients experienced heart failure progression (hospitalization and/or heart transplantation and/or death due to worsening heart failure). Considered as a continuous variable, RRI was associated with events at univariate [hazard ratio (HR) 1.14; 95% confidence interval (CI) 1.09-1.19; P < 0.001] as well as at multivariate Cox regression analysis (HR 1.08; 95% CI 1.02-1.13; P = 0.004) after correction for independent predictors of the reference model. When the RRI was added to the reference model including GFR, a significant improvement of reclassification according to both category-free net reclassification improvement (NRI, 47%; 95% CI 13-80%; P = 0.006) and integrated discrimination improvement (IDI, 0.034; 95% CI 0.006-0.061; P = 0.016) was observed.<br />Conclusions: Quantification of arterial renal perfusion provides a new parameter that independently predicts CHF patient outcome, thus strengthening its possible role in current clinical practice in order to better characterize renal function and stratify patients' prognosis.<br /> (© 2013 The Authors. European Journal of Heart Failure © 2013 European Society of Cardiology.)
- Subjects :
- Aged
Cardio-Renal Syndrome diagnostic imaging
Cardio-Renal Syndrome physiopathology
Chronic Disease
Cohort Studies
Disease Progression
Echocardiography, Doppler, Color
Female
Heart Failure diagnostic imaging
Humans
Kidney diagnostic imaging
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Prognosis
Proportional Hazards Models
Prospective Studies
Renal Artery physiopathology
Ultrasonography, Doppler, Pulsed
Heart Failure physiopathology
Kidney blood supply
Renal Artery diagnostic imaging
Vascular Resistance physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0844
- Volume :
- 16
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- European journal of heart failure
- Publication Type :
- Academic Journal
- Accession number :
- 24464953
- Full Text :
- https://doi.org/10.1002/ejhf.34