Have a personal or library account? Click to login
Assessing volume status in heart failure: The role of renal duplex ultrasound in evaluating cardiorenal morbidity and heart failure mortality Cover

Assessing volume status in heart failure: The role of renal duplex ultrasound in evaluating cardiorenal morbidity and heart failure mortality

Open Access
|Jul 2025

Figures & Tables

Fig. 1.

Correlation between RRI, venous flow pattern, and proBNP RRI≥0.75 (0=no, 1=yes) VFP (1=Continuous, 2= biphasic, 3=monophasic)
Correlation between RRI, venous flow pattern, and proBNP RRI≥0.75 (0=no, 1=yes) VFP (1=Continuous, 2= biphasic, 3=monophasic)

Fig. 2.

ROC curve for prediction of Acute Kidney Injury using RRI, venous flow pattern, proBNP, SOFA, GWTG, and ADHERE
ROC curve for prediction of Acute Kidney Injury using RRI, venous flow pattern, proBNP, SOFA, GWTG, and ADHERE

Fig. 3.

The classification of each stage of AKI based on RRI and the classification of each stage of AKI according to the VFP (RRI≥0.75 (0=no, 1=yes) VFP (1=Continuous, 2= biphasic, 3=monophasic)
The classification of each stage of AKI based on RRI and the classification of each stage of AKI according to the VFP (RRI≥0.75 (0=no, 1=yes) VFP (1=Continuous, 2= biphasic, 3=monophasic)

Fig. 4.

Classification of the incidence of in-hospital mortality (A), the incidence of readmission to hospital within 3 months (B), and 3-month mortality (C) according to VFP (1=Continuous, 2= biphasic, 3=monophasic)
Classification of the incidence of in-hospital mortality (A), the incidence of readmission to hospital within 3 months (B), and 3-month mortality (C) according to VFP (1=Continuous, 2= biphasic, 3=monophasic)

Fig. 5.

Classification of the incidence of readmission to hospital within 3 months (A) and the incidence of 3-month mortality (B) according to RRI (RRI≥0.75 (0=no, 1=yes)
Classification of the incidence of readmission to hospital within 3 months (A) and the incidence of 3-month mortality (B) according to RRI (RRI≥0.75 (0=no, 1=yes)

Correlation between RRI, venous flow pattern, and parameters of volume status of patients

ParametersRRI≥0.75Venous flow patter

Yes (n=20)No (n=41)P-valueContinuous (n=30)Biphasic (n=17)Monophasic (n=14)P-value
New York heart association class2n=1 (5%)n=3 (7.3%) n=4 (13.3%)n=0 (0.0%)n=0 (0.0%)
3n=6 (30%)n=18 (43.9%)0.622n=17 (56.7%)n=7 (41.2%)n=0 (0.0%)< 0.001
4n=13 (65%)n=20 (48.8%) n=9 (30%)n=10 (58.8%)n=14 (100%)

Central venous pressure (cmH2o)17.00±4.0814.49±4.60.04512.20±3.3217.41±4.0019.43±2.79< 0.001
Lower limb edeman=12 (60%)n=27 (65.9%)0.655n=17 (56.7%)n=8 (47.1%)n=14 (100%)0.005
3rd heart soundn=5 (25%)n=3 (7.3%)0.100n=1 (3.3%)n=1 (5.9%)n=6 (42.9%)0.002
Pulmonary Ralesn=15 (75%)n=23 (56.1%)0.153n=14 (46.7%)n=12 (70.6%)n=12 (85.7%)0.032

Chest X-ray findings:No specific findingsn=3 (15%)n=17 (41.5%) n=13 (43.3%)n=6 (35.3%)n=1 (7.1%)< 0.001
Cardiomegalyn=1 (5%)n=11 (26.8%) n=11 (36.7%)n=0 (0.0%)n=1 (7.1%)
Vascular cephalizationn=4 (20%)n=5 (12.2%)0.004n=3 (10%)n=4 (23.5%)n=2 (14.3%)
Interstitial edeman=8 (40%)n=7 (17.1%) n=3 (10%)n=6 (35.3%)n=6 (42.9%)
Alveolar edeman=4 (20%)n=1 (2.4%) n=0 (0.0%)n=1 (5.9%)n=4 (28.6%)

IVC collapsibility19.61±4.6324.77±6.03<0.00127.57±4.3520.60±3.7216.46±3.110.019
ProBNP(pg.\ml)8400± 4086.65310± 2627.70.0024171.67± 1658.927158.82± 27329918.57± 3832.36< 0.001
PaO2/FiO2 ratio288.40±47.51313.37±42.730.043327.40±26.83303.82±37.03259.21±53.40< 0.001

Comparisons between morbidity and mortality-related data after its classification according to RRI and VFP

RRI>=0.75venous flow pattern


Yes (n=20)No (n=41)P-valueContinuous (n=30)Biphasic (n=17)Monophasic (n=14)P-value
Noninvasive ventilationn=6 (30.0%)n=3 (7.3%)0.048n=1 (3.3%)n=2 (11.8%)n=6 (42.9%)0.004
Invasive mechanical ventilationn=1 (5.0%)n=2 (4.9%)1n=0 (0.0%)n=0 (0.0%)n=3 (21.4%)0.010
failure of NIV to IMVn=1 (5.0%)n=0 (0.0%)0.328n=0 (0.0%)n=1 (5.9%)n=0 (0.0%)0.508
length of hospital stays (days)7.40±2.566.05±2.340.0455.37±1.716.82±2.408.502.710.165
In-hospital mortalityn=4 (20.0%)n=2 (4.9%)0.084n=0 (0.0%)n=1 (5.9%)n=5 (35.7%)<0.001
Survival time within 3 months-follow up (days)53.35±36.883.90±18.70.00289.10±4.973.18±28.642.14±36.7< 0.001
Readmission within 3 monthsn=13 (65%)n=7 (17%)< 0.001n=3 (10.0%)n=9 (52.9%)n=8 (57.1%)< 0.001
3-months mortalityn=7 (35.0%)n=4 (9.8%)0.030n=1 (3.3%)n=5 (29.4%)n=5 (35.7%)0.005
SOFA score4.85±3.011.95±1.76<0.0011.50±1.222.94±1.715.86±3.25<0.001
ADHERE risk score1.70±0.471.29±0.460.0021.23±0.431.47±0.511.79±0.43<0.001
GWTG-HF score50.15±12.4741.02±10.90.00538.13±7.3642.18±7.7858.86±12.920.002
DOI: https://doi.org/10.2478/jccm-2025-0029 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 275 - 289
Submitted on: Feb 26, 2025
Accepted on: Jun 25, 2025
Published on: Jul 31, 2025
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2025 Mohamed Elsayed Elrokh, Waleed Shehata Hassan, Ramadan Ahmed Khalil, Ayman Nehad Moharam, Emad Eldin Omar Abdelaziz, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.