The role of the renal resistance index in patients with heart failure with reduced or preserved ejection fraction

J Cardiol. 2021 Oct;78(4):301-307. doi: 10.1016/j.jjcc.2021.05.007. Epub 2021 Jun 2.

Abstract

Background: Renal impairment is a common phenomenon that portends a poor prognosis of heart failure (HF). The renal arterial resistance index (RRI) can be useful for defining renal function and predicting outcomes in patients with HF. This study aimed to investigate the determining factors of the RRI in HF patients with preserved ejection fraction (HFpEF) and with reduced EF (HFrEF).

Methods: This retrospective study included 330 patients with HF. We investigated the determining factors for the RRI and the association between the RRI and 1-year composite outcome, comprising all-cause mortality and re-hospitalization for HF.

Results: The independent predictors of the RRI were tricuspid regurgitation peak gradient and estimated glomerular filtration rate in HFpEF, and pulse pressure and blood urea nitrogen in HFrEF. During the follow-up, 30 (9.1%) patients presented the composite outcome. Cox proportional hazard analysis revealed the association of the RRI with the composite outcome in both HFrEF (HR 1.08; 95% CI 1.03-1.14) and HFpEF (HR 1.07; 95% CI 1.03-1.12) without an interaction (p for interaction = 0.770).

Conclusions: The RRI was a consistent prognosticator in patients with HFpEF and those with HFrEF, while factors defining RRI were different between these groups.

Keywords: Heart failure with preserved ejection fraction; Heart failure with reduced ejection fraction; Renal resistance index.

MeSH terms

  • Heart Failure*
  • Hospitalization
  • Humans
  • Kidney / physiology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Stroke Volume
  • Ventricular Function, Left