{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T16:07:26Z","timestamp":1792858046848,"version":"4.5.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,5]]},"abstract":"\n Background<\/jats:title>\n Persistent congestion with deteriorating renal function is an important cause of adverse outcomes in heart failure. We aimed to characterize new approaches to evaluate renal congestion using Doppler ultrasonography.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We enrolled 205 patients with suspected or prediagnosed pulmonary hypertension (\n PH<\/jats:styled-content>\n ) undergoing right heart catheterization. Patients underwent renal Doppler ultrasonography and assessment of invasive cardiopulmonary hemodynamics, echocardiography, renal function, intra\u2010abdominal pressure, and neurohormones and hydration status. Four spectral Doppler intrarenal venous flow patterns and a novel renal venous stasis index (\n RVSI<\/jats:styled-content>\n ) were defined. We evaluated\n PH<\/jats:styled-content>\n \u2010related morbidity using the Cox proportional hazards model for the composite end point of\n PH<\/jats:styled-content>\n progression (hospitalization for worsening\n PH<\/jats:styled-content>\n , lung transplantation, or\n PH<\/jats:styled-content>\n \u2010specific therapy escalation) and all\u2010cause mortality for 1\u2010year after discharge. The prognostic utility of\n RVSI<\/jats:styled-content>\n and intrarenal venous flow patterns was compared using receiver operating characteristic curves.\n RVSI<\/jats:styled-content>\n increased in a graded fashion across increasing severity of intrarenal venous flow patterns (\n P<\/jats:italic>\n <0.0001) and was significantly associated with right heart and renal function, intra\u2010abdominal pressure, and neurohormonal and hydration status. During follow\u2010up, the morbidity\/mortality end point occurred in 91 patients and was independently predicted by\n RVSI<\/jats:styled-content>\n (\n RVSI<\/jats:styled-content>\n in the third tertile versus referent: hazard ratio: 4.72 [95% CI, 2.10\u201310.59;\n P<\/jats:italic>\n <0.0001]). Receiver operating characteristic curves suggested superiority of\n RVSI<\/jats:styled-content>\n to individual intrarenal venous flow patterns in predicting outcome (areas under the curve: 0.789 and 0.761, respectively;\n P<\/jats:italic>\n =0.038).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n We propose\n RVSI<\/jats:styled-content>\n as a conceptually new and integrative Doppler index of renal congestion.\n RVSI<\/jats:styled-content>\n provides additional prognostic information to stratify\n PH<\/jats:styled-content>\n for the propensity to develop right heart failure.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n https:\/\/www.clinicaltrials.gov\/<\/jats:ext-link>\n . Unique identifier:\n NCT<\/jats:styled-content>\n 03039959.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013584","type":"journal-article","created":{"date-parts":[[2019,10,19]],"date-time":"2019-10-19T05:00:22Z","timestamp":1571461222000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":111,"title":["Doppler\u2010Derived Renal Venous Stasis Index in the Prognosis of Right Heart Failure"],"prefix":"10.1161","volume":"8","author":[{"given":"Faeq","family":"Husain\u2010Syed","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"},{"name":"Division of Pulmonology and Critical Care Medicine Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"},{"name":"International Renal Research Institute of Vicenza Department of Nephrology, Dialysis and Transplantation San Bortolo Hospital Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst\u2010Walter","family":"Birk","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Ronco","sequence":"additional","affiliation":[{"name":"International Renal Research Institute of Vicenza Department of Nephrology, Dialysis and Transplantation San Bortolo Hospital Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Sch\u00f6rmann","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khodr","family":"Tello","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Critical Care Medicine Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"},{"name":"Member of the German Centre for Lung Research (DZL) Universities of Giessen and Marburg Lung Centre (UGMLC) Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel J.","family":"Richter","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Critical Care Medicine Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"},{"name":"Member of the German Centre for Lung Research (DZL) Universities of Giessen and Marburg Lung Centre (UGMLC) Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Wilhelm","sequence":"additional","affiliation":[{"name":"Member of the German Centre for Lung Research (DZL) Universities of Giessen and Marburg Lung Centre (UGMLC) Giessen 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University Hospital Giessen and Marburg Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u2010Dieter","family":"Walmrath","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Critical Care Medicine Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"},{"name":"Member of the German Centre for Lung Research (DZL) Universities of Giessen and Marburg Lung Centre (UGMLC) Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Seeger","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"},{"name":"Division of Pulmonology and Critical Care Medicine Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"},{"name":"Member of the German Centre for Lung Research (DZL) Universities of Giessen and Marburg Lung Centre (UGMLC) Giessen Germany"},{"name":"Max Planck Institute for Heart and Lung Research Bad Nauheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"McCullough","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute Baylor University Medical Center at Dallas TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Gall","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Critical Care Medicine Department of Internal Medicine II University Hospital Giessen and Marburg Giessen Germany"},{"name":"Member of the German Centre for Lung Research (DZL) Universities of Giessen and Marburg Lung Centre (UGMLC) Giessen Germany"},{"name":"Department of Epidemiology Erasmus MC Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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