Heart failure & cardiomyopathies
Intrarenal Venous Doppler as a novel marker for optimal decongestion, patient management, and prognosis in Acute Decompensated Heart Failure
Authors' conclusion
Decongestion may be associated with improvements in many clinical and instrumental parameters, but only VDPimp was associated with better clinical outcomes.
Study context
- Population
- Acute decompensated heart failure (ADHF) patients requiring IV diuretic therapy for ≥48 h, December 2018–January 2020177 screened
- Participants
- 72 patients
- Exposure
- Venous Doppler profiles (VDP) improvement vs no VDP improvement
- Outcome
- Death and rehospitalization
- Follow-up
- 60 days
Methodological detailsblinded intrarenal Doppler (IRD) examination
- Blinded IRD examination
Main finding
As reported in the abstract
VDPimp vs No VDPimpHazard ratio (95% CI)P value
Readmission
0.22(0.05–0.94)
P = 0.04Death
0.07(0.01–0.68)
P = 0.02- Readmitted
- 12 (16.7%)
- Died
- 9 (12.5%)
- Significantly better outcomes in VDP improvement (VDPimp) patients (log-rank)
- P < 0.05
Observational data: associations, not effects.
Further findings
VDP derangement · Day 1 to Day 5
- Decreased from 79.2% to 51.4%
- P < 0.05
Resistive index (RI) elevation (>0.8) · Day 1 to Day 5
- Decreased from 60.6% to 43.1%
- P < 0.05
VDPimp · Day 5
- VDPimp registered
- 59.7%
Signs of congestion, fluid accumulation, haematocrit, BNP · Day 5
- Improved
- P > 0.05
Original publication
Intrarenal Venous Doppler as a novel marker for optimal decongestion, patient management, and prognosis in Acute Decompensated Heart Failure. Eur Heart J Acute Cardiovasc Care. Published 5 July 2023. doi:10.
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