Abstract 17880: Impact of Cardiac Sympathetic Nerve Activity on Worsening Renal Function in Patients with Chronic Heart Failure
Background : Chronic heart failure (CHF) and renal dysfunction frequently coexist. Cardiac sympathetic nerve activity (CSNA) influence the clinical outcome in CHF patients, but there is little information available on the relation between CSNA and renal dysfunction in CHF patients.
Method : We enrolled 113 CHF outpatients with radionuclide LVEF<40% (30±8 %). The cardiac MIBG washout rate(WR) was calculated from the chest anterior view images obtained at 20 and 200 min after isotope injection. Abnormal WR was defined as >27% as reported previously. At the entry, we measured serum creatinine level and repeated the measurement of serum creatinine level every at least 6 month after the entry, and the worsening renal function (WRF) was defined as an increase of more than 0.3mg/dl in baseline serum creatinine value.
Results : During the follow up period of 5.9±3.8 years, WRF was observed in 33 of 59 patients with abnormal WR and 24 of 54 with normal WR. Kaplan-Meier analysis revealed that patients with abnormal WR had a significantly higher risk of WRF than with those with normal WR (56% vs 44% p=0.0003, adjusted hazard ratio 2.2 (95% CI 1.2-3.9). Furthermore, patients with WRF had significantly higher risk of the hospitalization due to worsening heart failure (49% vs 18% p=0.009, hazard ratio 2.5 (95% CI 1.2-5.2).
Conclusion : In CHF patients, CSNA was associated with worsening renal function. Furthermore, patients with worsening renal function had poor outcome. Thus, CSNA might play an important role in the worsening renal function in CHF patients.
- © 2012 by American Heart Association, Inc.