Decreased cardiac output, venous congestion and the association with renal impairment in patients with cardiac dysfunction

Kevin Damman, Gerjan Navis, Tom D. J. Smilde, Adriaan A. Voors, Wim van der Bij, Dirk J. van Veldhuisen, Hans L. Hillege*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Renal failure in heart failure is related to decreased cardiac output. However, little is known about its association with venous congestion.

Aims: To investigate the relationship between venous congestion and glomerular filtration rate (GFR) in patients with cardiac dysfunction.

Methods and results: Right atrial pressure (RAP) and cardiac index (CI) were determined by right heart catheterisation in 51 patients with cardiac dysfunction, secondary to pulmonary hypertension. GFR and renal blood flow (RBF) were measured as I-125-lothalamate and I-131- Hippuran clearances, respectively. Mean age was 40 +/- 11 years and 69% of patients were female. GFR was 73 +/- 19 ml/min/1.73 m(2) with a CI of 2.1 +/- 0.7 l/min/m(2). In multivariate analysis, RBF (r=0.664, p

Conclusion: RBF is the main factor determining GFR in patients with cardiac dysfunction. Venous congestion, characterised by an increased RAP, adjusted for RBF is also related to GFR. Treatment to preserve GFR should not only focus on improvement of renal perfusion, but also on decreasing venous congestion. (C) 2007 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)872-878
Number of pages7
JournalEuropean Journal of Heart Failure
Volume9
Issue number9
DOIs
Publication statusPublished - Sep-2007

Keywords

  • heart failure
  • renal function
  • kidney
  • haemodynamics
  • venous congestion
  • CHRONIC HEART-FAILURE
  • RENIN-ANGIOTENSIN SYSTEM
  • SYMPATHETIC-NERVES
  • KIDNEY-FUNCTION
  • MYOCARDIAL-INFARCTION
  • NEURAL-CONTROL
  • PRESSURE
  • INHIBITION
  • THERAPY
  • ULTRAFILTRATION

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