In heart failure, echocardiographic parameters of right ventricular function are powerful tools to predict renal failure

Abstract Background Chronic kidney disease (CKD) has a high prevalence in patients with heart failure (HF) and is associated with prolonged hospitalization, increased need for intensive care and mortality. There is an urgent need to identify factors that influence the interaction between heart and k...

Full description

Saved in:
Bibliographic Details
Main Authors: Alexander Reinecke, Paulina Dißmann, Norbert Frey, Oliver J. Müller, Hatim Seoudy, Johanne Frank, Derk Frank, Martina E. Spehlmann
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:ESC Heart Failure
Subjects:
Online Access:https://doi.org/10.1002/ehf2.15176
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849722421664284672
author Alexander Reinecke
Paulina Dißmann
Norbert Frey
Oliver J. Müller
Hatim Seoudy
Johanne Frank
Derk Frank
Martina E. Spehlmann
author_facet Alexander Reinecke
Paulina Dißmann
Norbert Frey
Oliver J. Müller
Hatim Seoudy
Johanne Frank
Derk Frank
Martina E. Spehlmann
author_sort Alexander Reinecke
collection DOAJ
description Abstract Background Chronic kidney disease (CKD) has a high prevalence in patients with heart failure (HF) and is associated with prolonged hospitalization, increased need for intensive care and mortality. There is an urgent need to identify factors that influence the interaction between heart and kidney disorders, often described as cardiorenal syndrome (CRS). We investigated the epidemiology and risk factors of renal insufficiency in patients with HF. Methods We conducted a retrospective cohort study including 281 consecutive patients with HF that are examined at regular intervals at our outpatient clinic for HF. CKD was defined as the presence of an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 and worsening renal function (WRF) was defined as a decrease of eGFR > 15% within a year. We assessed the patient's medical history, laboratory and echocardiographic parameters at baseline and after 12 months. Results Right ventricular dysfunction was associated with CKD and WRF. In particular, echocardiographic parameters ‘tricuspid annular plane systolic excursion (TAPSE) < 15 mm’ (P < 0.001; OR 2.932), ‘tricuspid regurgitation (TR) > I°’ [P < 0.001; odds ratio (OR) 5.958] and dilatation of inferior vena cava (IVC) (P < 0.001; OR 3.670) were significantly correlated with renal failure. N‐terminal pro‐B‐type natriuretic peptide levels were significantly associated with CKD (P < 0.001; OR 6.109) and correlated with pressure and volume load of the right heart. Conclusions The results of this work support the theory of right‐sided cardiac backward failure, often accompanied by hypervolaemia, as a leading cause of HF‐related renal failure. Right heart parameters, especially TR, TAPSE and IVC, are obtained easily by transthoracic echocardiography and can predict renal failure.
format Article
id doaj-art-ee463a24e76048cc8218d2d71802384d
institution DOAJ
issn 2055-5822
language English
publishDate 2025-06-01
publisher Wiley
record_format Article
series ESC Heart Failure
spelling doaj-art-ee463a24e76048cc8218d2d71802384d2025-08-20T03:11:21ZengWileyESC Heart Failure2055-58222025-06-011232310232010.1002/ehf2.15176In heart failure, echocardiographic parameters of right ventricular function are powerful tools to predict renal failureAlexander Reinecke0Paulina Dißmann1Norbert Frey2Oliver J. Müller3Hatim Seoudy4Johanne Frank5Derk Frank6Martina E. Spehlmann7Department of Internal Medicine III (Cardiology and Intensive Care Medicine) University Hospital Schleswig‐Holstein (UKSH) Kiel GermanyDepartment of Internal Medicine III (Cardiology and Intensive Care Medicine) University Hospital Schleswig‐Holstein (UKSH) Kiel GermanyDepartment of Internal Medicine III University Heidelberg Heidelberg GermanyDepartment of Internal Medicine V (Angiology) University Hospital Schleswig‐Holstein (UKSH) Kiel GermanyDepartment of Internal Medicine III (Cardiology and Intensive Care Medicine) University Hospital Schleswig‐Holstein (UKSH) Kiel GermanyDepartment of Internal Medicine III (Cardiology and Intensive Care Medicine) University Hospital Schleswig‐Holstein (UKSH) Kiel GermanyDepartment of Internal Medicine III (Cardiology and Intensive Care Medicine) University Hospital Schleswig‐Holstein (UKSH) Kiel GermanyDepartment of Internal Medicine III (Cardiology and Intensive Care Medicine) University Hospital Schleswig‐Holstein (UKSH) Kiel GermanyAbstract Background Chronic kidney disease (CKD) has a high prevalence in patients with heart failure (HF) and is associated with prolonged hospitalization, increased need for intensive care and mortality. There is an urgent need to identify factors that influence the interaction between heart and kidney disorders, often described as cardiorenal syndrome (CRS). We investigated the epidemiology and risk factors of renal insufficiency in patients with HF. Methods We conducted a retrospective cohort study including 281 consecutive patients with HF that are examined at regular intervals at our outpatient clinic for HF. CKD was defined as the presence of an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 and worsening renal function (WRF) was defined as a decrease of eGFR > 15% within a year. We assessed the patient's medical history, laboratory and echocardiographic parameters at baseline and after 12 months. Results Right ventricular dysfunction was associated with CKD and WRF. In particular, echocardiographic parameters ‘tricuspid annular plane systolic excursion (TAPSE) < 15 mm’ (P < 0.001; OR 2.932), ‘tricuspid regurgitation (TR) > I°’ [P < 0.001; odds ratio (OR) 5.958] and dilatation of inferior vena cava (IVC) (P < 0.001; OR 3.670) were significantly correlated with renal failure. N‐terminal pro‐B‐type natriuretic peptide levels were significantly associated with CKD (P < 0.001; OR 6.109) and correlated with pressure and volume load of the right heart. Conclusions The results of this work support the theory of right‐sided cardiac backward failure, often accompanied by hypervolaemia, as a leading cause of HF‐related renal failure. Right heart parameters, especially TR, TAPSE and IVC, are obtained easily by transthoracic echocardiography and can predict renal failure.https://doi.org/10.1002/ehf2.15176chronic kidney diseaseheart failureinferior vena cavaright ventricular dysfunctionTAPSEtricuspid regurgitation
spellingShingle Alexander Reinecke
Paulina Dißmann
Norbert Frey
Oliver J. Müller
Hatim Seoudy
Johanne Frank
Derk Frank
Martina E. Spehlmann
In heart failure, echocardiographic parameters of right ventricular function are powerful tools to predict renal failure
ESC Heart Failure
chronic kidney disease
heart failure
inferior vena cava
right ventricular dysfunction
TAPSE
tricuspid regurgitation
title In heart failure, echocardiographic parameters of right ventricular function are powerful tools to predict renal failure
title_full In heart failure, echocardiographic parameters of right ventricular function are powerful tools to predict renal failure
title_fullStr In heart failure, echocardiographic parameters of right ventricular function are powerful tools to predict renal failure
title_full_unstemmed In heart failure, echocardiographic parameters of right ventricular function are powerful tools to predict renal failure
title_short In heart failure, echocardiographic parameters of right ventricular function are powerful tools to predict renal failure
title_sort in heart failure echocardiographic parameters of right ventricular function are powerful tools to predict renal failure
topic chronic kidney disease
heart failure
inferior vena cava
right ventricular dysfunction
TAPSE
tricuspid regurgitation
url https://doi.org/10.1002/ehf2.15176
work_keys_str_mv AT alexanderreinecke inheartfailureechocardiographicparametersofrightventricularfunctionarepowerfultoolstopredictrenalfailure
AT paulinadißmann inheartfailureechocardiographicparametersofrightventricularfunctionarepowerfultoolstopredictrenalfailure
AT norbertfrey inheartfailureechocardiographicparametersofrightventricularfunctionarepowerfultoolstopredictrenalfailure
AT oliverjmuller inheartfailureechocardiographicparametersofrightventricularfunctionarepowerfultoolstopredictrenalfailure
AT hatimseoudy inheartfailureechocardiographicparametersofrightventricularfunctionarepowerfultoolstopredictrenalfailure
AT johannefrank inheartfailureechocardiographicparametersofrightventricularfunctionarepowerfultoolstopredictrenalfailure
AT derkfrank inheartfailureechocardiographicparametersofrightventricularfunctionarepowerfultoolstopredictrenalfailure
AT martinaespehlmann inheartfailureechocardiographicparametersofrightventricularfunctionarepowerfultoolstopredictrenalfailure