Abstract
BACKGROUND: The prognostic relevance of plasma volume reduction (PVR) in acute heart failure patients remains unclear because of the confounding hemodynamic effect of left ventricular ejection fraction impairment on kidney function.
METHODS AND RESULTS: Subjects enrolled in the West Tokyo Heart Failure Registry were examined. The PV at admission and discharge was estimated from the subjects' body weight and its deviation from the ideal body weight. Patients in the top tertile of estimated PVR were classified as PVR+. Of the 381 patients with acute heart failure, 181 (47.5%) had heart failure with preserved ejection fraction (HFpEF). Estimated PVR was associated with worsening renal function in the HFpEF (odds ratio, 3.28; 95% confidence interval, 1.55-6.96; P=0.002) but not in the heart failure with reduced ejection fraction cohort (odds ratio, 1.22; 95% confidence interval, 0.61-2.42; P=0.57). This association in the HFpEF cohort remained significant after adjusting for a history of hypertension and diabetes mellitus and the estimated glomerular filtration rate (odds ratio, 3.34; 95% confidence interval, 1.52-7.33; P=0.003). The use of intravenous diuretics was a significant predictor of PVR in the HFpEF and heart failure with reduced ejection fraction groups.
CONCLUSIONS: The effect of estimated PVR differs by HF type, and the estimated PVR during hospitalization is a predictor of worsening renal function in patients with HFpEF but not in heart failure with reduced ejection fraction.
CLINICAL TRIAL REGISTRATION: URL: http://www.umin.ac.jp/ctr/index-j.html. Unique identifier: UMIN000001549.
| Original language | English |
|---|---|
| Pages (from-to) | 527-532 |
| Number of pages | 6 |
| Journal | Circulation: Heart Failure |
| Volume | 8 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2015 May 1 |
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Keywords
- diuretics
- heart failure
- heart failure, diastolic
- plasma
ASJC Scopus subject areas
- Medicine(all)
Cite this
Effect of estimated plasma volume reduction on renal function for acute heart failure differs between patients with preserved and reduced ejection fraction. / West Tokyo Heart Failure Registry Investigators.
In: Circulation: Heart Failure, Vol. 8, No. 3, 01.05.2015, p. 527-532.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of estimated plasma volume reduction on renal function for acute heart failure differs between patients with preserved and reduced ejection fraction
AU - West Tokyo Heart Failure Registry Investigators
AU - Takei, Makoto
AU - Kohsaka, Shun
AU - Shiraishi, Yasuyuki
AU - Goda, Ayumi
AU - Izumi, Yuki
AU - Yagawa, Mayuko
AU - Mizuno, Atsushi
AU - Sawano, Mitsuaki
AU - Inohara, Taku
AU - Kohno, Takashi
AU - Fukuda, Keiichi
AU - Yoshikawa, Tsutomu
PY - 2015/5/1
Y1 - 2015/5/1
N2 - BACKGROUND: The prognostic relevance of plasma volume reduction (PVR) in acute heart failure patients remains unclear because of the confounding hemodynamic effect of left ventricular ejection fraction impairment on kidney function.METHODS AND RESULTS: Subjects enrolled in the West Tokyo Heart Failure Registry were examined. The PV at admission and discharge was estimated from the subjects' body weight and its deviation from the ideal body weight. Patients in the top tertile of estimated PVR were classified as PVR+. Of the 381 patients with acute heart failure, 181 (47.5%) had heart failure with preserved ejection fraction (HFpEF). Estimated PVR was associated with worsening renal function in the HFpEF (odds ratio, 3.28; 95% confidence interval, 1.55-6.96; P=0.002) but not in the heart failure with reduced ejection fraction cohort (odds ratio, 1.22; 95% confidence interval, 0.61-2.42; P=0.57). This association in the HFpEF cohort remained significant after adjusting for a history of hypertension and diabetes mellitus and the estimated glomerular filtration rate (odds ratio, 3.34; 95% confidence interval, 1.52-7.33; P=0.003). The use of intravenous diuretics was a significant predictor of PVR in the HFpEF and heart failure with reduced ejection fraction groups.CONCLUSIONS: The effect of estimated PVR differs by HF type, and the estimated PVR during hospitalization is a predictor of worsening renal function in patients with HFpEF but not in heart failure with reduced ejection fraction.CLINICAL TRIAL REGISTRATION: URL: http://www.umin.ac.jp/ctr/index-j.html. Unique identifier: UMIN000001549.
AB - BACKGROUND: The prognostic relevance of plasma volume reduction (PVR) in acute heart failure patients remains unclear because of the confounding hemodynamic effect of left ventricular ejection fraction impairment on kidney function.METHODS AND RESULTS: Subjects enrolled in the West Tokyo Heart Failure Registry were examined. The PV at admission and discharge was estimated from the subjects' body weight and its deviation from the ideal body weight. Patients in the top tertile of estimated PVR were classified as PVR+. Of the 381 patients with acute heart failure, 181 (47.5%) had heart failure with preserved ejection fraction (HFpEF). Estimated PVR was associated with worsening renal function in the HFpEF (odds ratio, 3.28; 95% confidence interval, 1.55-6.96; P=0.002) but not in the heart failure with reduced ejection fraction cohort (odds ratio, 1.22; 95% confidence interval, 0.61-2.42; P=0.57). This association in the HFpEF cohort remained significant after adjusting for a history of hypertension and diabetes mellitus and the estimated glomerular filtration rate (odds ratio, 3.34; 95% confidence interval, 1.52-7.33; P=0.003). The use of intravenous diuretics was a significant predictor of PVR in the HFpEF and heart failure with reduced ejection fraction groups.CONCLUSIONS: The effect of estimated PVR differs by HF type, and the estimated PVR during hospitalization is a predictor of worsening renal function in patients with HFpEF but not in heart failure with reduced ejection fraction.CLINICAL TRIAL REGISTRATION: URL: http://www.umin.ac.jp/ctr/index-j.html. Unique identifier: UMIN000001549.
KW - diuretics
KW - heart failure
KW - heart failure, diastolic
KW - plasma
UR - http://www.scopus.com/inward/record.url?scp=84938489688&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84938489688&partnerID=8YFLogxK
U2 - 10.1161/CIRCHEARTFAILURE.114.001734
DO - 10.1161/CIRCHEARTFAILURE.114.001734
M3 - Article
C2 - 25737498
AN - SCOPUS:84938489688
VL - 8
SP - 527
EP - 532
JO - Circulation: Heart Failure
JF - Circulation: Heart Failure
SN - 1941-3297
IS - 3
ER -