دورية أكاديمية
أعرض في EDS

The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker.

التفاصيل البيبلوغرافية
العنوان: The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker.
المؤلفون: Andrew BY; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina; Clinical Research Training Program, Duke University School of Medicine, Durham, North Carolina., Cherry AD; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina., Hauck JN; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina., Nicoara A; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina., Maxwell CD; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina., Konoske RM; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina., Thompson A; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina., Kartha LD; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina., Swaminathan M; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina., Stafford-Smith M; Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina. Electronic address: mark.staffordsmit@dm.duke.edu.
المصدر: The Annals of thoracic surgery [Ann Thorac Surg] 2018 Jul; Vol. 106 (1), pp. 107-114. Date of Electronic Publication: 2018 Feb 07.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 15030100R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-6259 (Electronic) Linking ISSN: 00034975 NLM ISO Abbreviation: Ann Thorac Surg
أسماء مطبوعة: Publication: Amsterdam : Elsevier
Original Publication: Boston.
مواضيع طبية MeSH: Acute Kidney Injury/*etiology , Aortic Valve Insufficiency/*surgery , Aortic Valve Stenosis/*surgery , Heart Valve Prosthesis Implantation/*adverse effects , Vascular Resistance/*physiology, Acute Kidney Injury/diagnostic imaging ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/physiopathology ; Age Factors ; Aged ; Aortic Valve/physiopathology ; Aortic Valve/surgery ; Aortic Valve Insufficiency/diagnostic imaging ; Aortic Valve Stenosis/diagnostic imaging ; Biomarkers/analysis ; Blood Flow Velocity/physiology ; Cardiopulmonary Bypass/adverse effects ; Cardiopulmonary Bypass/methods ; Case-Control Studies ; Databases, Factual ; Female ; Heart Valve Prosthesis Implantation/methods ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Assessment ; Sex Factors ; Survival Analysis ; Ultrasonography, Doppler/methods
مستخلص: Background: Acute kidney injury (AKI) is a common serious complication after cardiac surgery. Doppler-determined renal resistive index (RRI) is a promising early AKI biomarker in this population. However, the relationship between aortic valve pathology (insufficiency and/or stenosis) and RRI is unknown. This study aimed to investigate RRI variability related to aortic valve pathology.
Methods: In a retrospective review of cardiac surgery patients, RRI and aortic valve pathology were assessed prior to cardiopulmonary bypass using transesophageal echocardiography. Aortic valve status was categorized into four subgroups: normal (insufficiency and stenosis, none/trace/mild), insufficiency (insufficiency, moderate/severe; stenosis, none/trace/mild), combined insufficiency/stenosis (insufficiency and stenosis, moderate/severe), or stenosis (insufficiency, none/trace/mild; stenosis, moderate/severe). RRI and time-matched hemodynamic and Doppler measurements were compared among subgroups.
Results: Of 175 patients, 60 had aortic valve pathology (16 insufficiency, 18 insufficiency/stenosis, 26 stenosis). Compared with the normal subgroup, patients with aortic insufficiency had lower diastolic blood pressure and trough renal Doppler velocities, and higher RRI (0.77 versus 0.69; p < 0.001); patients with combined insufficiency/stenosis also had higher RRI (0.72 versus 0.69, p = 0.042).
Conclusions: Patients with aortic insufficiency and combined insufficiency/stenosis had higher median RRI values compared with normal patients. For these individuals, diastolic flow differences related to aortic insufficiency may explain why their presurgery RRI values often exceeded postoperative thresholds typically associated with AKI. Strategies to account for the potentially confounding effects of aortic insufficiency on renal flow patterns, independent of renal injury, may add to the value of RRI as an early AKI biomarker.
(Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
التعليقات: Comment in: J Thorac Dis. 2018 Nov;10(Suppl 33):S3914-S3918. (PMID: 30631515)
Comment in: J Thorac Dis. 2018 Nov;10(Suppl 33):S4010-S4012. (PMID: 30631541)
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معلومات مُعتمدة: T32 GM008600 United States GM NIGMS NIH HHS; TL1 TR001116 United States TR NCATS NIH HHS
المشرفين على المادة: 0 (Biomarkers)
تواريخ الأحداث: Date Created: 20180211 Date Completed: 20190808 Latest Revision: 20190808
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC6019136
DOI: 10.1016/j.athoracsur.2018.01.020
PMID: 29427619
قاعدة البيانات: MEDLINE
الوصف
تدمد:1552-6259
DOI:10.1016/j.athoracsur.2018.01.020