Impact of Central Venous Pressure on Cardiorenal Interactions in Adult Patients with Congenital Heart Disease after Biventricular Repair

Abstract

Hemodynamics, especially a high CVP, independently predicted the enlarged kidney and abnormal intrarenal flow dynamics that are closely associated with heart failure severity and cardiovascular events in adults with CHD after biventricular repair.

Central Venous Pressure Dropped Early is Associated with Organ Function and Prognosis in Septic Shock Patients

“…In patients with chronic heart failure, high CVP was an independent risk factor for kidney injury (7). In adults with congenital heart disease, a high CVP was associated with abnormal intrarenal flow dynamics (3). It is clear that most of the studies on the association between CVP and kidney function were in patients with heart failure, with few studies in patients with septic shock.…”

“…Similarly, CVP as an indicator of volume status may also affect organ function. In recent years, studies of the effects of CVP on organ function or prognosis have generally been carried out on patients with heart failure (2)(3)(4)(5)(6)(7), with few studies on patients with septic shock. Moreover, the consecutive changes of CVP and organ function cannot be expressed in detail because of less time points in previous studies (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)17,18).…”

Renal resistive index reflects Fontan pathophysiology and predicts mortality

“…Furthermore, the RRI reflects the pathophysiology of sleep apnoea and predicts the mortality of patients with heart failure associated with a preserved left ventricular ejection fraction who typically suffer from multiple comorbidities 5 6. We have previously demonstrated the RRI to be a useful marker of heart failure severity and the predicted prognosis for adult patients with congenital heart disease following a biventricular repair 7. However, the clinical significance of the RRI has been unclear regarding Fontan patients, for which the high central venous pressure (CVP) and low cardiac output may have a significant influence on the anatomy and function of the kidneys.…”

Experience of decortication for restrictive hemodynamics in adults with congenital heart disease

“…Those comorbidities are, however, very rare in our ACHD patients. In our RH patients, on the other hand, severe right‐side heart failure results in renal venous congestion and may lead to renal failure.…”