PDF(Pubmed)
Abstract：
UNASSIGNED: Worsening renal function is a frequent finding in patients with acute decompensated heart failure (ADHF) and is a powerful independent prognostic factor for adverse outcomes. The link between abdominal congestion and worsening renal function in such patients is not yet fully addressed.
UNASSIGNED: To evaluate the role of abdominal congestion in the early prediction of worsening renal function in hospitalized patients with acute decompensated heart failure.
UNASSIGNED: This was a prospective study that enrolled 100 patients with a diagnosis of ADHF and received intravenous diuretic therapy. Intra-abdominal pressure (IAP), splenic Doppler impedance indices and serum prouroguanylin were measured on admission, 24 h after admission and on discharge. Patients were then divided into 2 groups: those who developed WRF (WRF group), and those who did not (non-WRF group). Worsening renal function was defined as an increase in serum creatinine level ≥0.3 mg/dL above baseline admission value. Intrabdominal pressure was measured transvesically using standard Foley catheter. Splenic Doppler impedance indices (resistivity and pulsatility indices) were measured using splenic Doppler ultrasound.
UNASSIGNED: Among recruited patients (age: 54.73 ± 13.1 years, 72% are male), there was a significant decline in IAP (6.67 mmHg vs 8.36 mmHg, p = 0.001) and significant rise in splenic resistivity index (0.69 vs 0.67, p = 0.002) before discharge compared to admission values. The median level of serum prouroguanylin before discharge showed significant decline compared to admission level (29.2 vs 34.6 ng/l, p = 0.006). WRF developed in 37 (37%) patients. Independent predictors of WRF during hospitalization were high splenic arterial resistivity index 24 h after admission, high intra-abdominal pressure (≥8 mmHg) 24 h after admission, and low LVEF on admission.
UNASSIGNED: In ADHF patients receiving diuretic therapy, transvesical measurement of intra-abdominal pressure and splenic resistivity index by splenic Doppler early after admission can help to identify patients at increased risk of WRF near discharge.
UNASSIGNED: To evaluate the role of abdominal congestion in the early prediction of worsening renal function in hospitalized patients with acute decompensated heart failure.
UNASSIGNED: This was a prospective study that enrolled 100 patients with a diagnosis of ADHF and received intravenous diuretic therapy. Intra-abdominal pressure (IAP), splenic Doppler impedance indices and serum prouroguanylin were measured on admission, 24 h after admission and on discharge. Patients were then divided into 2 groups: those who developed WRF (WRF group), and those who did not (non-WRF group). Worsening renal function was defined as an increase in serum creatinine level ≥0.3 mg/dL above baseline admission value. Intrabdominal pressure was measured transvesically using standard Foley catheter. Splenic Doppler impedance indices (resistivity and pulsatility indices) were measured using splenic Doppler ultrasound.
UNASSIGNED: Among recruited patients (age: 54.73 ± 13.1 years, 72% are male), there was a significant decline in IAP (6.67 mmHg vs 8.36 mmHg, p = 0.001) and significant rise in splenic resistivity index (0.69 vs 0.67, p = 0.002) before discharge compared to admission values. The median level of serum prouroguanylin before discharge showed significant decline compared to admission level (29.2 vs 34.6 ng/l, p = 0.006). WRF developed in 37 (37%) patients. Independent predictors of WRF during hospitalization were high splenic arterial resistivity index 24 h after admission, high intra-abdominal pressure (≥8 mmHg) 24 h after admission, and low LVEF on admission.
UNASSIGNED: In ADHF patients receiving diuretic therapy, transvesical measurement of intra-abdominal pressure and splenic resistivity index by splenic Doppler early after admission can help to identify patients at increased risk of WRF near discharge.
摘要：
■肾功能恶化是急性失代偿性心力衰竭（ADHF）患者的常见表现，并且是不良预后的有力独立预后因素。此类患者的腹部充血与肾功能恶化之间的联系尚未完全解决。
■评估腹部充血在急性失代偿性心力衰竭住院患者肾功能恶化的早期预测中的作用。
■这是一项前瞻性研究，纳入100例诊断为ADHF并接受静脉利尿剂治疗的患者。腹内压(IAP),入院时测量脾多普勒阻抗指数和血清前鸟苷酸，入院后和出院后24小时。然后将患者分为2组：开发WRF的患者（WRF组），和那些没有（非WRF组）。肾功能恶化定义为血清肌酐水平升高≥0.3mg/dL，高于基线入院值。使用标准Foley导管经膀胱测量腹内压。使用脾多普勒超声测量脾多普勒阻抗指数（电阻率和搏动指数）。
■在招募的患者中（年龄：54.73±13.1岁，72%是男性)，IAP显着下降（6.67mmHg对8.36mmHg，p=0.001），与入院值相比，出院前脾电阻率指数显着上升（0.69vs0.67，p=0.002）。出院前血清前鸟苷素的中位数水平与入院水平相比显着下降（29.2vs34.6ng/l，p=0.006)。37例（37%）患者出现WRF。住院期间WRF的独立预测因素是入院后24h脾动脉电阻率指数高，入院后24小时腹内压升高（≥8mmHg），入学时LVEF低。
■在接受利尿剂治疗的ADHF患者中，入院后早期通过脾多普勒经膀胱测量腹内压和脾电阻率指数可帮助识别WRF接近出院风险增加的患者。
■评估腹部充血在急性失代偿性心力衰竭住院患者肾功能恶化的早期预测中的作用。
■这是一项前瞻性研究，纳入100例诊断为ADHF并接受静脉利尿剂治疗的患者。腹内压(IAP),入院时测量脾多普勒阻抗指数和血清前鸟苷酸，入院后和出院后24小时。然后将患者分为2组：开发WRF的患者（WRF组），和那些没有（非WRF组）。肾功能恶化定义为血清肌酐水平升高≥0.3mg/dL，高于基线入院值。使用标准Foley导管经膀胱测量腹内压。使用脾多普勒超声测量脾多普勒阻抗指数（电阻率和搏动指数）。
■在招募的患者中（年龄：54.73±13.1岁，72%是男性)，IAP显着下降（6.67mmHg对8.36mmHg，p=0.001），与入院值相比，出院前脾电阻率指数显着上升（0.69vs0.67，p=0.002）。出院前血清前鸟苷素的中位数水平与入院水平相比显着下降（29.2vs34.6ng/l，p=0.006)。37例（37%）患者出现WRF。住院期间WRF的独立预测因素是入院后24h脾动脉电阻率指数高，入院后24小时腹内压升高（≥8mmHg），入学时LVEF低。
■在接受利尿剂治疗的ADHF患者中，入院后早期通过脾多普勒经膀胱测量腹内压和脾电阻率指数可帮助识别WRF接近出院风险增加的患者。
