Skip to main content
SpringerLink
Log in

Patient with Severe Right Heart Failure and Preserved Left Ventricular Ejection Function

  • Chapter
  • First Online:
Cardiorenal Syndrome in Heart Failure

  • 942 Accesses

Abstract

Worsening of renal failure is a frequent complication of acute decompensated right heart failure. Right heart failure may lead to chronic kidney disease that may be aggravated during acute episodes. In addition to treat the cause of this acute heart failure, renal dysfunction related to acute right side failure requires a thorough evaluation of patient volume status, an optimization of blood pressure and cardiac output and an active decongestion. An echocardiographic follow-up of RV function and tricuspid valve regurgitation are of utmost importance. Biomarkers associated with congestion (BNP, CD146,…) may be of help to prevent and treat this complication.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chatterjee NA, Steiner J, Lewis GD. It is time to look at heart failure with preserved ejection fraction from the right side. Circulation. 2014;130(25):2272–7.

    Article  Google Scholar 

  2. Zakeri R, Mohammed SF. Epidemiology of right ventricular dysfunction in heart failure with preserved ejection fraction. Curr Heart Fail Rep. 2015;12(5):295–301.

    Article  Google Scholar 

  3. Harjola V-P, Mebazaa A, Čelutkienė J, Bettex D, Bueno H, Chioncel O, et al. Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology. Eur J Heart Fail. 2016;18(3):226–41.

    Article  Google Scholar 

  4. McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012;14(8):803–69.

    Article  CAS  Google Scholar 

  5. Sztrymf B, Souza R, Bertoletti L, Jaïs X, Sitbon O, Price LC, et al. Prognostic factors of acute heart failure in patients with pulmonary arterial hypertension. Eur Respir J. 2010;35(6):1286–93.

    Article  CAS  Google Scholar 

  6. Gorter TM, van Veldhuisen DJ, Bauersachs J, Borlaug BA, Celutkiene J, Coats AJS, et al. Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(1):16–37.

    Article  Google Scholar 

  7. Aschauer S, Kammerlander AA, Zotter-Tufaro C, Ristl R, Pfaffenberger S, Bachmann A, et al. The right heart in heart failure with preserved ejection fraction: insights from cardiac magnetic resonance imaging and invasive haemodynamics. Eur J Heart Fail. 2016;18(1):71–80.

    Article  Google Scholar 

  8. Ter Maaten JM, Damman K, Verhaar MC, Paulus WJ, Duncker DJ, Cheng C, et al. Connecting heart failure with preserved ejection fraction and renal dysfunction: the role of endothelial dysfunction and inflammation. Eur J Heart Fail. 2016;18(6):588–98.

    Article  Google Scholar 

  9. McAlister FA, Ezekowitz J, Tarantini L, Squire I, Komajda M, Bayes-Genis A, et al. Renal dysfunction in patients with heart failure with preserved versus reduced ejection fraction: impact of the new Chronic Kidney Disease-Epidemiology Collaboration Group formula. Circ Heart Fail. 2012;5(3):309–14.

    Article  Google Scholar 

  10. Damman K, Valente MAE, Voors AA, O’Connor CM, van Veldhuisen DJ, Hillege HL. Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis. Eur Heart J. 2014;35(7):455–69.

    Article  Google Scholar 

  11. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2:S1–138.

    Google Scholar 

  12. Voors AA, Gori M, Liu LCY, Claggett B, Zile MR, Pieske B, et al. Renal effects of the angiotensin receptor neprilysin inhibitor LCZ696 in patients with heart failure and preserved ejection fraction. Eur J Heart Fail. 2015;17(5):510–7.

    Article  CAS  Google Scholar 

  13. Gottlieb SS, Abraham W, Butler J, Forman DE, Loh E, Massie BM, et al. The prognostic importance of different definitions of worsening renal function in congestive heart failure. J Card Fail. 2002;8(3):136–41.

    Article  Google Scholar 

  14. Schrier RW. Blood urea nitrogen and serum creatinine: not married in heart failure. Circ Heart Fail. 2008;1(1):2–5.

    Article  CAS  Google Scholar 

  15. Damman K, Masson S, Hillege HL, Voors AA, van Veldhuisen DJ, Rossignol P, et al. Tubular damage and worsening renal function in chronic heart failure. JACC Heart Fail. 2013;1(5):417–24.

    Article  Google Scholar 

  16. Damman K, Masson S, Hillege HL, Maggioni AP, Voors AA, Opasich C, et al. Clinical outcome of renal tubular damage in chronic heart failure. Eur Heart J. 2011;32(21):2705–12.

    Article  CAS  Google Scholar 

  17. Paulus WJ, Tschöpe C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol. 2013;62(4):263–71.

    Article  Google Scholar 

  18. Melenovsky V, Cervenka L, Viklicky O, Franekova J, Havlenova T, Behounek M, et al. Kidney response to heart failure: proteomic analysis of cardiorenal syndrome. Kidney Blood Press Res. 2018;43(5):1437–50.

    Article  CAS  Google Scholar 

  19. Sharma UC, Pokharel S, van Brakel TJ, van Berlo JH, Cleutjens JPM, Schroen B, et al. Galectin-3 marks activated macrophages in failure-prone hypertrophied hearts and contributes to cardiac dysfunction. Circulation. 2004;110(19):3121–8.

    Article  CAS  Google Scholar 

  20. Frenay A-RS, Yu L, van der Velde AR, Vreeswijk-Baudoin I, López-Andrés N, van Goor H, et al. Pharmacological inhibition of galectin-3 protects against hypertensive nephropathy. Am J Physiol Renal Physiol. 2015;308(5):F500–9.

    Article  CAS  Google Scholar 

  21. Ljungman S, Laragh JH, Cody RJ. Role of the kidney in congestive heart failure. Relationship of cardiac index to kidney function. Drugs. 1990;39 Suppl 4:10–21; discussion 22–24.

    Article  CAS  Google Scholar 

  22. Damman K, Navis G, Smilde TDJ, Voors AA, van der Bij W, van Veldhuisen DJ, et al. Decreased cardiac output, venous congestion and the association with renal impairment in patients with cardiac dysfunction. Eur J Heart Fail. 2007;9(9):872–8.

    Article  Google Scholar 

  23. Damman K, van Deursen VM, Navis G, Voors AA, van Veldhuisen DJ, Hillege HL. Increased central venous pressure is associated with impaired renal function and mortality in a broad spectrum of patients with cardiovascular disease. J Am Coll Cardiol. 2009;53(7):582–8.

    Article  Google Scholar 

  24. Mullens W, Abrahams Z, Francis GS, Sokos G, Taylor DO, Starling RC, et al. Importance of venous congestion for worsening of renal function in advanced decompensated heart failure. J Am Coll Cardiol. 2009;53(7):589–96.

    Article  Google Scholar 

  25. Strobeck JE, Feldschuh J, Miller WL. Heart failure outcomes with volume-guided management. JACC Heart Fail. 2018;6:940–8.

    Article  Google Scholar 

  26. Binanay C, Califf RM, Hasselblad V, O’Connor CM, Shah MR, Sopko G, et al. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA. 2005;294(13):1625–33.

    Article  Google Scholar 

  27. Matsue Y, Damman K, Voors AA, Kagiyama N, Yamaguchi T, Kuroda S, et al. Time-to-furosemide treatment and mortality in patients hospitalized with acute heart failure. J Am Coll Cardiol. 2017;69(25):3042–51.

    Article  Google Scholar 

  28. Yilmaz MB, Gayat E, Salem R, Lassus J, Nikolaou M, Laribi S, et al. Impact of diuretic dosing on mortality in acute heart failure using a propensity-matched analysis. Eur J Heart Fail. 2011;13(11):1244–52.

    Article  CAS  Google Scholar 

  29. Schrier RW. Role of diminished renal function in cardiovascular mortality: marker or pathogenetic factor? J Am Coll Cardiol. 2006;47(1):1–8.

    Article  Google Scholar 

  30. Abdallah JG, Schrier RW, Edelstein C, Jennings SD, Wyse B, Ellison DH. Loop diuretic infusion increases thiazide-sensitive Na(+)/Cl(-)-cotransporter abundance: role of aldosterone. J Am Soc Nephrol. 2001;12(7):1335–41.

    CAS  PubMed  Google Scholar 

  31. De Vecchis R, Esposito C, Ariano C. Efficacy and safety assessment of isolated ultrafiltration compared to intravenous diuretics for acutely decompensated heart failure: a systematic review with meta-analysis. Minerva Cardioangiol. 2014;62(2):131–46.

    PubMed  Google Scholar 

  32. Matsue Y, Suzuki M, Torii S, Yamaguchi S, Fukamizu S, Ono Y, et al. Clinical effectiveness of tolvaptan in patients with acute heart failure and renal dysfunction. J Card Fail. 2016;22(6):423–32.

    Article  CAS  Google Scholar 

  33. Konstam MA, Gheorghiade M, Burnett JC, Grinfeld L, Maggioni AP, Swedberg K, et al. Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST Outcome Trial. JAMA. 2007;297(12):1319–31.

    Article  CAS  Google Scholar 

  34. Mullens W, Verbrugge FH, Nijst P, Martens P, Tartaglia K, Theunissen E, et al. Rationale and design of the ADVOR (Acetazolamide in Decompensated Heart Failure with Volume Overload) trial. Eur J Heart Fail. 2018;20:1591–600.

    Article  CAS  Google Scholar 

  35. Ghignone M, Girling L, Prewitt RM. Volume expansion versus norepinephrine in treatment of a low cardiac output complicating an acute increase in right ventricular afterload in dogs. Anesthesiology. 1984;60(2):132–5.

    Article  CAS  Google Scholar 

  36. Pierrakos C, Velissaris D, Franchi F, Muzzi L, Karanikolas M, Scolletta S. Levosimendan in critical illness: a literature review. J Clin Med Res. 2014;6(2):75–85.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Yilmaz MB, Yontar C, Erdem A, Karadas F, Yalta K, Turgut OO, et al. Comparative effects of levosimendan and dobutamine on right ventricular function in patients with biventricular heart failure. Heart Vessels. 2009;24(1):16–21.

    Article  Google Scholar 

  38. Morelli A, Teboul J-L, Maggiore SM, Vieillard-Baron A, Rocco M, Conti G, et al. Effects of levosimendan on right ventricular afterload in patients with acute respiratory distress syndrome: a pilot study. Crit Care Med. 2006;34(9):2287–93.

    Article  CAS  Google Scholar 

  39. Nath J, Foster E, Heidenreich PA. Impact of tricuspid regurgitation on long-term survival. J Am Coll Cardiol. 2004;43(3):405–9.

    Article  Google Scholar 

  40. Sadeghpour A, Hassanzadeh M, Kyavar M, Bakhshandeh H, Naderi N, Ghadrdoost B, et al. Impact of severe tricuspid regurgitation on long term survival. Res Cardiovasc Med. 2013;2(3):121–6.

    Article  Google Scholar 

  41. Beldhuis IE, Streng KW, Ter Maaten JM, Voors AA, van der Meer P, Rossignol P, et al. Renin-angiotensin system inhibition, worsening renal function, and outcome in heart failure patients with reduced and preserved ejection fraction: a meta-analysis of published study data. Circ Heart Fail. 2017;10(2)

    Google Scholar 

  42. Damman K, Testani JM. The kidney in heart failure: an update. Eur Heart J. 2015;36(23):1437–44.

    Article  Google Scholar 

  43. Van Aelst LNL, Arrigo M, Placido R, Akiyama E, Girerd N, Zannad F, et al. Acutely decompensated heart failure with preserved and reduced ejection fraction present with comparable haemodynamic congestion. Eur J Heart Fail. 2018;20(4):738–47.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anaesthesiology and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Paris, France

    Anaïs Caillard, Benjamin G. Chousterman & Alexandre Mebazaa

  2. INSERM U942 MASCOT, Paris, France

    Anaïs Caillard, Benjamin G. Chousterman & Alexandre Mebazaa

Authors
  1. Anaïs Caillard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Benjamin G. Chousterman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexandre Mebazaa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benjamin G. Chousterman .

Editor information

Editors and Affiliations

  1. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA

    W. H. Wilson Tang

  2. Department of Internal Medicine, UZ Leuven, Leuven, Belgium

    Frederik H. Verbrugge

  3. Ziekenhuis Oost-Limburg, Genk University Hasselt, Genk, Belgium

    Wilfried Mullens

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Caillard, A., Chousterman, B.G., Mebazaa, A. (2020). Patient with Severe Right Heart Failure and Preserved Left Ventricular Ejection Function. In: Tang, W., Verbrugge, F., Mullens, W. (eds) Cardiorenal Syndrome in Heart Failure. Springer, Cham. https://doi.org/10.1007/978-3-030-21033-5_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-21033-5_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21032-8

  • Online ISBN: 978-3-030-21033-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation