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...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15176 |
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| 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 |
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