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心肾综合征中心脏右心功能的变化。

Right Heart Function in Cardiorenal Syndrome.

机构信息

Klinik III Für Innere Medizin, Herzzentrum Der Universität Zu Köln, Köln, Germany.

Cologne Cardiovascular Research Center (CCRC), Klinikum Der Universität Zu Köln, Köln, Germany.

出版信息

Curr Heart Fail Rep. 2022 Dec;19(6):386-399. doi: 10.1007/s11897-022-00574-x. Epub 2022 Sep 27.

Abstract

PURPOSE OF REVIEW

Since CRS is critically dependent on right heart function and involved in interorgan crosstalk, assessment and monitoring of both right heart and kidney function are of utmost importance for clinical outcomes. This systematic review aims to comprehensively report on novel diagnostic and therapeutic paradigms that are gaining importance for the clinical management of the growing heart failure population suffering from CRS.

RECENT FINDINGS

Cardiorenal syndrome (CRS) in patients with heart failure is associated with poor outcome. Although systemic venous congestion and elevated central venous pressure have been recognized as main contributors to CRS, they are often neglected in clinical practice. The delicate hemodynamic balance in CRS is particularly determined by the respective status of the right heart. The consideration of hemodynamic and CRS profiles is advantageous in tailoring treatment for better preservation of renal function. Assessment and monitoring of right heart and renal function by known and emerging tools like renal Doppler ultrasonography or new biomarkers may have direct clinical implications.

摘要

目的综述

由于 CRS 严重依赖右心功能,并涉及器官间的相互作用,因此评估和监测右心和肾功能对于临床结局至关重要。本系统综述旨在全面报告新的诊断和治疗模式,这些模式对于日益增多的心力衰竭合并 CRS 患者的临床管理具有重要意义。

最近的发现

心力衰竭患者的心脏肾综合征(CRS)与不良预后相关。尽管全身静脉淤血和中心静脉压升高已被认为是 CRS 的主要原因,但在临床实践中往往被忽视。CRS 中微妙的血流动力学平衡主要由右心的各自状态决定。考虑血流动力学和 CRS 特征有利于通过更好地保留肾功能来调整治疗。通过已知和新兴工具(如肾脏多普勒超声或新的生物标志物)评估和监测右心和肾功能可能具有直接的临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e87d/9653308/f6a89df63f72/11897_2022_574_Fig1_HTML.jpg

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