BACKGROUND: In patients with heart failure with preserved ejection fraction (HFpEF), worse kidney function is associated with worse overall cardiac mechanics. Right ventricular stroke work index (RVSWI) is a parameter of right ventricular function. The aim of our study was to determine the relationship between RVSWI and glomerular filtration rate (GFR) in patients with HFpEF. METHOD: This was a single-center cross-sectional study. HFpEF is defined as patients with documented heart failure with ejection fraction > 50% and pulmonary wedge pressure > 15 mm Hg from right heart catheterization. RVSWI (normal value 8-12 g/m/beat/m2) was calculated using the formula: RVSWI = 0.0136 × stroke volume index × (mean pulmonary artery pressure - mean right atrial pressure). Univariate and multivariate linear regression analysis was performed to study the correlation between RVSWI and GFR. RESULT: Ninety-one patients were included in the study. The patients were predominantly female (n = 64, 70%) and African American (n = 61, 67%). Mean age was 66 ± 12 years. Mean GFR was 59 ± 35 mL/min/1.73 m2. Mean RVSWI was 11 ± 6 g/m/beat/m2. Linear regression analysis showed that there was a significant independent inverse relationship between RVSWI and GFR (unstandardized coefficient = -1.3, p = 0.029). In the subgroup with combined post and precapillary pulmonary hypertension (Cpc-PH) the association remained significant (unstandardized coefficient = -1.74, 95% CI -3.37 to -0.11, p = 0.04). CONCLUSION: High right ventricular workload indicated by high RVSWI is associated with worse renal function in patients with Cpc-PH. Further prospective studies are needed to better understand this association.
BACKGROUND: In patients with heart failure with preserved ejection fraction (HFpEF), worse kidney function is associated with worse overall cardiac mechanics. Right ventricular stroke work index (RVSWI) is a parameter of right ventricular function. The aim of our study was to determine the relationship between RVSWI and glomerular filtration rate (GFR) in patients with HFpEF. METHOD: This was a single-center cross-sectional study. HFpEF is defined as patients with documented heart failure with ejection fraction > 50% and pulmonary wedge pressure > 15 mm Hg from right heart catheterization. RVSWI (normal value 8-12 g/m/beat/m2) was calculated using the formula: RVSWI = 0.0136 × stroke volume index × (mean pulmonary artery pressure - mean right atrial pressure). Univariate and multivariate linear regression analysis was performed to study the correlation between RVSWI and GFR. RESULT: Ninety-one patients were included in the study. The patients were predominantly female (n = 64, 70%) and African American (n = 61, 67%). Mean age was 66 ± 12 years. Mean GFR was 59 ± 35 mL/min/1.73 m2. Mean RVSWI was 11 ± 6 g/m/beat/m2. Linear regression analysis showed that there was a significant independent inverse relationship between RVSWI and GFR (unstandardized coefficient = -1.3, p = 0.029). In the subgroup with combined post and precapillary pulmonary hypertension (Cpc-PH) the association remained significant (unstandardized coefficient = -1.74, 95% CI -3.37 to -0.11, p = 0.04). CONCLUSION: High right ventricular workload indicated by high RVSWI is associated with worse renal function in patients with Cpc-PH. Further prospective studies are needed to better understand this association.
Authors: Jean-Luc Vachiéry; Yochai Adir; Joan Albert Barberà; Hunter Champion; John Gerard Coghlan; Vincent Cottin; Teresa De Marco; Nazzareno Galiè; Stefano Ghio; J Simon R Gibbs; Fernando Martinez; Marc Semigran; Gerald Simonneau; Athol Wells; Werner Seeger Journal: J Am Coll Cardiol Date: 2013-12-24 Impact factor: 24.094
Authors: Frank L Dini; Ryan T Demmer; Anca Simioniuc; Doralisa Morrone; Francesca Donati; Giacinta Guarini; Enrico Orsini; Paolo Caravelli; Mario Marzilli; Paolo C Colombo Journal: Eur J Heart Fail Date: 2012-03 Impact factor: 15.534
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Authors: Erin D Unger; Ruth F Dubin; Rajat Deo; Vistasp Daruwalla; Julie L Friedman; Crystal Medina; Lauren Beussink; Benjamin H Freed; Sanjiv J Shah Journal: Eur J Heart Fail Date: 2015-12-03 Impact factor: 15.534
Authors: Hilary F Armstrong; P Christian Schulze; Tomoko S Kato; Matthew Bacchetta; Wilawan Thirapatarapong; Matthew N Bartels Journal: J Heart Lung Transplant Date: 2013-04-06 Impact factor: 10.247
Authors: Stephan Rosenkranz; J Simon R Gibbs; Rolf Wachter; Teresa De Marco; Anton Vonk-Noordegraaf; Jean-Luc Vachiéry Journal: Eur Heart J Date: 2015-10-27 Impact factor: 29.983