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

Publication ,  Journal Article
Andrew, BY; Cherry, AD; Hauck, JN; Nicoara, A; Maxwell, CD; Konoske, RM; Thompson, A; Kartha, LD; Swaminathan, M; Stafford-Smith, M
Published in: Ann Thorac Surg
July 2018

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.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

July 2018

Volume

106

Issue

1

Start / End Page

107 / 114

Location

Netherlands

Related Subject Headings

  • Vascular Resistance
  • Ultrasonography, Doppler
  • Survival Analysis
  • Sex Factors
  • Risk Assessment
  • Retrospective Studies
  • Respiratory System
  • Prognosis
  • Middle Aged
  • Male
 

Citation

APA
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ICMJE
MLA
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Andrew, B. Y., Cherry, A. D., Hauck, J. N., Nicoara, A., Maxwell, C. D., Konoske, R. M., … Stafford-Smith, M. (2018). The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker. Ann Thorac Surg, 106(1), 107–114. https://doi.org/10.1016/j.athoracsur.2018.01.020
Andrew, Benjamin Y., Anne D. Cherry, Jennifer N. Hauck, Alina Nicoara, Cory D. Maxwell, Ryan M. Konoske, Annemarie Thompson, Lakshmi D. Kartha, Madhav Swaminathan, and Mark Stafford-Smith. “The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker.Ann Thorac Surg 106, no. 1 (July 2018): 107–14. https://doi.org/10.1016/j.athoracsur.2018.01.020.
Andrew BY, Cherry AD, Hauck JN, Nicoara A, Maxwell CD, Konoske RM, et al. The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker. Ann Thorac Surg. 2018 Jul;106(1):107–14.
Andrew, Benjamin Y., et al. “The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker.Ann Thorac Surg, vol. 106, no. 1, July 2018, pp. 107–14. Pubmed, doi:10.1016/j.athoracsur.2018.01.020.
Andrew BY, Cherry AD, Hauck JN, Nicoara A, Maxwell CD, Konoske RM, Thompson A, Kartha LD, Swaminathan M, Stafford-Smith M. The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker. Ann Thorac Surg. 2018 Jul;106(1):107–114.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

July 2018

Volume

106

Issue

1

Start / End Page

107 / 114

Location

Netherlands

Related Subject Headings

  • Vascular Resistance
  • Ultrasonography, Doppler
  • Survival Analysis
  • Sex Factors
  • Risk Assessment
  • Retrospective Studies
  • Respiratory System
  • Prognosis
  • Middle Aged
  • Male