Cardio-Renal Syndrome Type 1: The Role of Central Venous Pressure and Left Ventricle Ejection Fraction

George Lobzhanidze

Abstract


The aim of the study has been to explore the association between increased Central Venous Pressure (CVP), Ejection Fraction (EF) and renal dysfunction (manifested as reduced eGFR<60) in patients with Cardio-Renal Syndrome (CRS) type 1. The pathophysiology of impaired renal function in cardiovascular disease is complex and multifactorial. Recent investigations indicate that management of patients based on low-flow theory only does not lead to improved outcomes. Importance of Right-Sided Heart Failure (RSHF) and increased CVP in this process has not been well evaluated. Proper understanding of bi-directional mechanism by which heart and kidneys influence each other, would lead to correct clinical management and better outcome. The retrospective cross-sectional study has been performed on patients with Acute Decompensated Heart Failure (ADHF) and reduced eGFR (CRS type 1). With a total number of 11 participants, Pearson correlation analysis has shown moderate downhill (negative) relationship between CVP and eGFR (r = -0.48, Sig. 0.14), while correlation between LVEF and eGFR has been found to be weaker (r = 0.12, Sig. 0.72). In this study with a small number of participants, although not statistically significant, the effect size is considerable, suggesting that CVP, rather than LVEF could be directly associated with impaired renal function in patients with CRS type 1. Based on these results, further research with more participants (at least 32) can be performed to validate the correlation.


Keywords


Cardio-Renal Syndrome; Right-Sided Heart Failure; Central Venous Pressure; Left Ventricle Ejection Fraction; eGFR; Low-flow theory.

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