Trial reportJournal of the American College of Cardiology2016
Reduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure.
Trial report in Journal of the American College of Cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers.
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Who cites it
61 citing papers in PubMed, 130 citations in OpenAlex.
- Rates of Reversal of Volume Overload in Hospitalized Acute Heart Failure: Association With Long-term Kidney Function.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Trial
- Hypoperfusion-Shock Continuum in Acute Decompensated Heart Failure.Circulation. Heart failure · 2026Review
- Ambulatory low cardiac output state in heart failure: characteristics and outcomes.ESC heart failure · 2026Article
- Device therapies in cardiorenal syndrome: an expert review.ESC heart failure · 2026Review
- Fluid Tolerance in Acute Kidney Injury: Is Point-of-Care Ultrasound the Future of Hemodynamic Assessment?Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Congestion and renal function in patients with chronic heart failure.ESC heart failure · 2026Article
- Relationship Between Central Venous Pressure, Cardiac Index, and Renal Function in Pediatric Heart Failure: a Pediatric Heart Transplant Society Study.Pediatric cardiology · 2026Article
- Extended venous excess ultrasound: A promising addition to point-of-care ultrasound-based venous congestion assessment.World journal of cardiology · 2026Review
- Renal congestion syndrome in critically ill patients: a neglected mechanism of acute kidney injury - A narrative review.Annals of intensive care · 2026Review
- Prognostic implications of echocardiographic and hemodynamic profiles in cirrhosis and high-output heart failure.Frontiers in cardiovascular medicine · 2026Article
- Point-of-care ultrasound: Uniting cardiology and nephrology at the bedside.World journal of cardiology · 2025Review
- Kidney injury in patients with heart failure-related cardiogenic shock: Results from an international, multicentre cohort study.European journal of heart failure · 2025Article
- Worsening Renal Function in Acute Heart Failure: Not Always Harmful.Current heart failure reports · 2025Review
- Kidneys Under Pressure: The Consequence of Heart Failure and Elevated Filling Pressures.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025Article
- Considerations on the predictive value of Fibrosis-4 index for improved renal function in AHFpEF.Clinical and experimental nephrology · 2025Article
- Article
- Novel Hemodynamic Markers and Kidney Function in Patients with Acute Decompensated Heart Failure.Kidney360 · 2025Article
- Cardiorenal syndrome: evolving concepts and pediatric knowledge gaps.Pediatric nephrology (Berlin, Germany) · 2025Review
- Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio and Cardiorenal Syndrome Type 2 in the Systemic Sclerosis EUSTAR Cohort.Arthritis care & research · 2025Article
- Mechanisms of Congestion in Acute Decompensated Heart Failure.Cardiorenal medicine · 2025Review
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundIt is widely believed that a reduced cardiac index (CI) is a significant contributor to renal dysfunction in patients with heart failure (HF). However, recent data have challenged this paradigm.
objectivesThis study sought to determine the relationship between CI and renal function in a multicenter population of HF patients undergoing pulmonary artery catheterization (PAC).
methodsPatients undergoing PAC in either the randomized or registry portions of the ESCAPE (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) trial were included (n = 575). We evaluated associations between CI and renal function across multiple subgroups and assessed for nonlinear, threshold, and longitudinal relationships.
resultsThere was a weak but significant inverse correlation between CI and estimated glomerular filtration rate (eGFR), such that higher CI was paradoxically associated with worse eGFR (r = -0.12; p = 0.02). CI was not associated with blood urea nitrogen (BUN) or the BUN to creatinine ratio. Similarly, no associations were observed between CI and better renal function across multiple subgroups defined by indications for PAC or hemodynamic, laboratory, or demographic parameters. A nonlinear or threshold effect could not be identified. In patients with serial assessments of renal function and CI, we were unable to find within-subject associations between change in CI and eGFR using linear mixed modeling. Neither CI nor change in CI was lower in patients developing worsening renal function (p ≥ 0.28).
conclusionsThese results reinforce evidence that reduced CI is not the primary driver for renal dysfunction in patients hospitalized for HF, irrespective of the degree of CI impairment or patient subgroup analyzed.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.