Komuro Kaoru, Shimazu Kyo, Koizumi Takuya, Imagawa Shogo, Anzai Teisuke, Yonezawa Kazuya
Department of Cardiology, National Hospital Organization Hakodate National Hospital Hakodate Japan.
Department of Clinical Research, National Hospital Organization Hakodate National Hospital Hakodate Japan.
Circ Rep. 2019 Nov 20;1(12):593-600. doi: 10.1253/circrep.CR-19-0024.
Renal congestion is a critical pathophysiological component of congestive heart failure (CHF). To quantify renal congestion, contrast-enhanced ultrasonography (CEUS) was performed at baseline and after treatment in 11 CHF patients and 9 normal subjects. Based on the time-contrast intensity curve, time to peak intensity (TTP), which reflects the perfusion rate of renal parenchyma, and relative contrast intensity (RCI), an index reflecting renal blood volume, were measured. In CHF patients, TTP at baseline was significantly prolonged compared with that in controls (cortex, 10.8±3.5 vs. 4.6±1.2 s, P<0.0001; medulla, 10.6±3.0 vs. 5.1±1.6 s, P<0.0001), and RCI was lower than that in controls (cortex, -16.5±5.2 vs. -8.8±1.5 dB, P<0.0001; medulla, -22.8±5.2 vs. -14.8±2.4 dB, P<0.0001). After CHF treatment, RCI was significantly increased (cortex, -16.5±5.2 to -11.8±4.5 dB, P=0.035; medulla, -22.8±5.2 to -18.7±3.7 dB, P=0.045). TTP in the cortex decreased after treatment (10.8±3.5 to 7.6±3.1 s, P=0.032), but it was unchanged in the medulla (10.6±3.0 to 8.3±3.2 s, P=0.098). Renal congestion can be observed using CEUS in CHF patients.
肾充血是充血性心力衰竭（CHF）的一个关键病理生理组成部分。为了量化肾充血情况，对11例CHF患者和9名正常受试者在基线期和治疗后进行了对比增强超声检查（CEUS）。根据时间-对比强度曲线，测量反映肾实质灌注率的达峰时间（TTP）以及反映肾血容量的指标相对对比强度（RCI）。在CHF患者中，基线期的TTP较对照组显著延长（皮质：10.8±3.5秒对4.6±1.2秒，P<0.0001；髓质：10.6±3.0秒对5.1±1.6秒，P<0.0001），且RCI低于对照组（皮质：-16.5±5.2分贝对-8.8±1.5分贝，P<0.0001；髓质：-22.8±5.2分贝对-14.8±2.4分贝，P<0.0001）。CHF治疗后，RCI显著增加（皮质：从-16.5±5.2分贝增至-11.8±4.5分贝，P=0.035；髓质：从-22.8±5.2分贝增至-18.7±3.7分贝，P=0.045）。治疗后皮质的TTP降低（10.8±3.5秒至7.6±3.1秒，P=0.032），但髓质的TTP无变化（10.6±3.0秒至8.3±3.2秒，P=0.098）。使用CEUS可观察到CHF患者的肾充血情况。
