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Echocardiographic predictors of worsening renal function in acute heart failure: observations from the RASHF registry

机译：急性心力衰竭中肾功能恶化的超声心动图预测因子：来自RASHF注册中心的观察

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Aims Echocardiography is known as the most useful diagnostic test in the assessment of patients with heart failure (HF), and the prognostic significance of echocardiographic findings in HF is well known. In this report, we aim to present the prognostic significance of a limited set of echocardiographic parameters obtained within 24?h of admission of patients enrolled in the Rajaie Acute Systolic Heart Failure registry. Methods and results A total of 230 patients with the diagnosis of acute systolic HF (left ventricular ejection fraction?≤?35%) were enrolled into the study. Transthoracic echocardiography was performed for all study population within 24?h of admission. The primary endpoint of the study was the occurrence of worsening renal function (WRF) during the hospitalization course.Acquiring data of transthoracic echocardiography within 24?h of admission was feasible in all study participants. The median (inter‐quartile range) of left ventricular ejection fraction was 20% (15–23%). Severe right ventricular dysfunction was observed in 21.5% of patients. The grade of inferior vena cava collapse and right ventricular systolic dysfunction were associated with WRF. In multivariable analysis, right ventricular systolic dysfunction was among the independent predictors of WRF [ β ?=?0.8, P ?=?0.01, odds ratio (OR)?=?2.4 (1.2–4.9)] and in‐hospital mortality [ β ?=?0.6, P ?=?0.04, OR?=?1.5 (0.5–4.6)]. Conclusions Echocardiographic parameters are useful for baseline assessment and provide additional information besides other clinical variables for prognostication. Right ventricular dysfunction is the most important risk factor in developing WRF and in‐hospital mortality in patients with acute HF.
机译：目的超声心动图检查是评估心力衰竭（HF）患者最有用的诊断测试，超声心动图检查结果对心衰的预后意义是众所周知的。在本报告中，我们旨在介绍在Rajaie急性收缩期心力衰竭登记处入院的患者入院后24小时内获得的有限超声心动图参数的预后意义。方法与结果本研究共纳入230例诊断为急性收缩期HF（左心室射血分数≤≤35％）的患者。入院24小时内对所有研究人群进行经胸超声心动图检查。该研究的主要终点是住院期间肾功能恶化（WRF）的发生。在入院后24小时之内获取经胸超声心动图数据对所有研究参与者都是可行的。左心室射血分数的中位数（四分位间距）为20％（15-23％）。在21.5％的患者中观察到严重的右心室功能障碍。下腔静脉塌陷程度和右心室收缩功能障碍与WRF相关。在多变量分析中，右心室收缩功能障碍是WRF的独立预测因素[β？=？0.8，P？=？0.01，优势比（OR）？=？2.4（1.2–4.9）]和院内死亡率[β α＝ 0.6，P ＝ 0.04，OR ＝ 1.5（0.5-4.6）。结论超声心动图参数可用于基线评估，并为其他预后指标提供其他信息。右心功能不全是急性心力衰竭患者发生WRF和院内死亡的最重要危险因素。

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