Iacoviello Massimo, Monitillo Francesco, Leone Marta, Citarelli Gaetano, Doronzo Annalisa, Antoncecchi Valeria, Puzzovivo Agata, Rizzo Caterina, Lattarulo Maria Silvia, Massari Francesco, Caldarola Pasquale, Ciccone Marco Matteo
Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Bari, Italy.
School of Cardiology, University of Bari, Bari, Italy.
Cardiorenal Med. 2016 Nov;7(1):42-49. doi: 10.1159/000448405. Epub 2016 Sep 21.
BACKGROUND/AIM: The renal arterial resistance index (RRI) is a Doppler measure, which reflects abnormalities in the renal blood flow. The aim of this study was to verify the value of RRI as a predictor of worsening renal function (WRF) in a group of chronic heart failure (CHF) outpatients.
We enrolled 266 patients in stable clinical conditions and on conventional therapy. Peak systolic velocity and end diastolic velocity of a segmental renal artery were obtained by pulsed Doppler flow, and RRI was calculated. Creatinine serum levels were evaluated at baseline and at 1 year, and the changes were used to assess WRF occurrence.
During follow-up, 34 (13%) patients showed WRF. RRI was associated with WRF at univariate (OR: 1.13; 95% CI: 1.07-1.20) as well as at a forward stepwise multivariate logistic regression analysis (OR: 1.09; 95% CI: 1.03-1.16; p = 0.005) including the other univariate predictors.
Quantification of arterial renal perfusion provides a new parameter that independently predicts the WRF in CHF outpatients. Its possible role in current clinical practice to better define the risk of cardiorenal syndrome progression is strengthened.
背景/目的:肾动脉阻力指数(RRI)是一种多普勒测量指标,可反映肾血流异常情况。本研究旨在验证RRI作为一组慢性心力衰竭(CHF)门诊患者肾功能恶化(WRF)预测指标的价值。
我们纳入了266例临床病情稳定且接受常规治疗的患者。通过脉冲多普勒血流获取节段性肾动脉的收缩期峰值速度和舒张末期速度,并计算RRI。在基线和1年时评估血清肌酐水平,并用其变化评估WRF的发生情况。
在随访期间,34例(13%)患者出现WRF。在单因素分析中,RRI与WRF相关(比值比:1.13;95%置信区间:1.07 - 1.20),在向前逐步多因素逻辑回归分析中也相关(比值比:1.09;95%置信区间:1.03 - 1.16;p = 0.005),该分析纳入了其他单因素预测指标。
肾动脉灌注的量化提供了一个独立预测CHF门诊患者WRF的新参数。其在当前临床实践中更好地定义心肾综合征进展风险的可能作用得到了加强。