Clinical Implications of Intrarenal Hemodynamic Evaluation by Doppler Ultrasonography in Heart Failure

Iida, Norimasa; Seo, Yoshihiro; Sai, Seika; Machino‐Ohtsuka, Tomoko; Yamamoto, Masayoshi; Ishizu, Tomoko; Kawakami, Yasushi; Aonuma, Kazutaka

doi:10.1016/j.jchf.2016.03.016

Cited by 240 publications

(267 citation statements)

References 30 publications

Supporting

Mentioning

225

Contrasting

Unclassified

Order By: Relevance

“…Marked increases in IVCD, LAD and biphasic intrarenal vein flow pattern were seen at the time of marked bradycardia, suggesting the occurrence of increased CVP and preload. The biphasic intrarenal vein flow pattern is likely to occur in patients with increased CVP 8. These indicated that increase in the central fluid volume occurred in this patient.…”

Section: Discussionmentioning

confidence: 65%

Maternal bradycardia occurring prior to onset of HELLP syndrome in a woman with pre-eclampsia

Hosokawa

Umazume²,

Yamada

et al. 2017

BMJ Case Reports

View full text Add to dashboard Cite

A 36-year-old nulliparous woman developed pre-eclampsia at gestational week (GW) 28 Cardiac status was checked regularly. Heart rate of 93 beats per minute (bpm) with left atrial diameter (LAD) of 35 mm, left ventricular hypertrophy and inferior vena cava diameter (IVCD) of 8 mm at GW 32 decreased to 48 bpm with an expanded IVCD to 25 mm, dilated left atrium (LAD to 39 mm), increased pulmonary arterial pressure, increased systemic vascular resistance (approximate 3000 dyn s/cm) and biphasic intrarenal venous flow pattern 3.5 hours prior to childbirth at GW 32 Epigastralgia, tachycardia (160 bpm) and marked hypertension (201/111 mm Hg) occurring 2 hours after echocardiography necessitated caesarean section, with subsequent development of HELLP syndrome. Acute fluid shift from the splanchnic vasculature to central vasculature may have occurred causing HELLP syndrome as a result from vasospasm associated with sympathetic hyperactivity. The cause of bradycardia prior to tachycardia remains unclear.

show abstract

Section: Discussionmentioning

confidence: 65%

Maternal bradycardia occurring prior to onset of HELLP syndrome in a woman with pre-eclampsia

Hosokawa

Umazume²,

Yamada

et al. 2017

BMJ Case Reports

View full text Add to dashboard Cite

show abstract

“…13, 14 Patients in each group were further divided into 2 subgroups according to the presence or absence of anemia.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Effect of Anemia on Cardiovascular Hemodynamics, Therapeutic Strategy and Clinical Outcomes in Patients With Heart Failure and Hemodynamic Congestion

Tanimura

Dohi

Fujimoto

et al. 2017

Circ J

View full text Add to dashboard Cite

Background:We investigated the effect of anemia on cardiovascular hemodynamics, therapeutic strategies and clinical outcomes in heart failure (HF) patients. Methods and Results:We divided 198 consecutive HF patients who underwent right heart catheterization before in-hospital HF treatment into 2 groups according to the presence or absence of hemodynamic congestion (HC: mean pulmonary capillary wedge pressure ≥15 mmHg and/or mean right atrial pressure ≥10 mmHg). The hemoglobin level correlated with the cardiac index (CI) and systemic vascular resistance index (SVRI) (r=−0.34 and 0.42, P<0.05, respectively), and was the strongest contributor of SVRI only in the HC group. Anemic patients more frequently required intravenous inotropic support despite having higher CI and lower SVRI than non-anemic patients in the HC group. The novel hemodynamic subsets based on mean right atrial pressure and estimated left ventricular stroke work index but not Forrester subsets appropriately predicted the need for intravenous inotropic support. The probability of hospitalization for worsening HF during 2-year follow-up period was significantly higher in anemic patients than in nonanemic patients in the HC group.Conclusions: Anemia had a direct effect on cardiovascular hemodynamics and thus can confound therapeutic planning in HF patients with HC. The novel hemodynamic subsets can be applied in daily clinical practice regardless of the presence or absence of anemia.

show abstract

“…This pattern may identify patients in the early phase of renal congestion. Differently from the study of Iida et al[45], there were no prognostic differences between polyphasic and monophasic intermittent patterns, they are both related to worse venous congestion and identify patients at higher risk[46]. …”

Section: Renal Venous Echo Doppler and Venous Patternsmentioning

confidence: 83%

“…Iida et al[45] evaluate intrarenal venous flow and VII in a population of outpatients and hospitalized patients affected by heart failure. They found three vein flow patterns: Continuous, biphasic discontinuous and monophasic discontinuous.…”

Section: Renal Venous Echo Doppler and Venous Patternsmentioning

confidence: 99%

See 1 more Smart Citation

Role of imaging in the evaluation of renal dysfunction in heart failure patients

Grande

Terlizzese

Iacoviello

2017

WJN

View full text Add to dashboard Cite

Heart failure and kidney disease share common pathophysiological pathways which can lead to mutual dysfunction, known as cardiorenal syndrome. In heart failure patients, renal impairment is related to hemodynamic and non-hemodynamic factors. Both decreased renal blood flow and renal venous congestion due to heart failure could lead to impaired renal function. Kidney disease and worsening renal function are independently associated with poor prognosis in heart failure patients, both in acute and chronic clinical settings. The aim of this review is to assess the role of renal imaging modalities in the evaluation and management of heart failure patients. Renal imaging techniques could complete laboratory data, as estimated glomerular filtration rate, exploring different pathophysiological factors involved in kidney disease and adding valuable information about renal structure and function. In particular, Doppler examination of arterial and venous hemodynamics is a feasible and non invasive technique, which has proven to be a reliable method for prognostic stratification in patients with cardiorenal syndrome. The renal resistance index, a measure related to renal hemodynamics, can be calculated from the Doppler evaluation of arterial flow. Moreover, the analysis of Doppler venous flow patterns can integrate information from the arterial study and evaluate renal congestion. Other imaging modalities are promising, but still confined to research purposes.

show abstract

Clinical Implications of Intrarenal Hemodynamic Evaluation by Doppler Ultrasonography in Heart Failure

Abstract: IRVF patterns, rather than RI, depended on RAP, suggesting a correlation with renal congestion. In addition, IRVF patterns strongly correlated with clinical outcomes independent of RAP and other risk factors and might provide additional information to stratify vulnerable HF patients.

Cited by 240 publications

References 30 publications

Maternal bradycardia occurring prior to onset of HELLP syndrome in a woman with pre-eclampsia

Maternal bradycardia occurring prior to onset of HELLP syndrome in a woman with pre-eclampsia

Effect of Anemia on Cardiovascular Hemodynamics, Therapeutic Strategy and Clinical Outcomes in Patients With Heart Failure and Hemodynamic Congestion

Role of imaging in the evaluation of renal dysfunction in heart failure patients

Contact Info

Product

Resources

About