RT Journal Article
SR Electronic
T1 Prognostic value of renal doppler in acute decompensated precapillary pulmonary hypertension
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA1925
DO 10.1183/13993003.congress-2021.PA1925
VO 58
IS suppl 65
A1 Jérémie Pichon
A1 Charles Fauvel
A1 Anne Roche
A1 Athénaïs Boucly
A1 Xavier Jaïs
A1 Mitja Jevnikar
A1 Nathan Ebstein
A1 Olivier Sitbon
A1 David Montani
A1 Marc Humbert
A1 Laurent Savale
YR 2021
UL http://erj.ersjournals.com/content/58/suppl_65/PA1925.abstract
AB Although cardiorenal syndrome has been identified as a major prognostic factor in right heart failure (RHF), the prognostic value of renal doppler has never been evaluated in acute decompensated precapillary pulmonary hypertension (PH).The aim of our study was to analyze the prognostic value of the arterial renal resistance index (RRI) and the doppler-derived renal venous stasis index (RVSI) assessed at admission and day-3 in precapillary PH patients admitted in intensive care unit (ICU) for acute RHF. The primary endpoint was a composite endpoint including death, circulatory assistance, urgent transplantation or rehospitalization for acute RHF within 90 days following inclusion.Among the 46 patients analysed (67% female, age 60±15 years), all received intravenous diuretics and 27 (57%) required inotropic and/or vasopressor support. At admission, the median values of RRI and RVSI were respectively 0.75 [IQR, 0.69-0.86] and 0.48 [IQR, 0.27-0.6]. RRI>0.75 was significantly associated with lower eGFR (p=0.023) and lower systemic mean arterial pressure (p=0.015). RVSI>0.48 was associated with lower eGFR (p=0.004), higher central venous pressure (p<0.001) and higher NT-proBNP (p=0.013). A primary endpoint event occurred in 12 patients (24%). In Kaplan–Meier analysis, the event rate was higher in patients with RRI>0.75 at admission (p=0.02) but not in patients with RVSI>0.48. At day-3, a decrease in both RRI and RVSI was associated with better outcomes (p=0.003 and p<0.0001, respectively). No event occurs in patients who improved both RRI and RVSI at Day 3.Arterial and venous renal doppler seem to be relevant tools for prognostic evaluation of acute decompensated precapillary PHFootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA1925.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).