Independent role of high central venous pressure in predicting worsening of renal function in chronic heart failure outpatients

In heart failure (HF) patients, an impairment of the renal function, as well as a worsening of this condition, is frequently observed and both have been demonstrated to be independently associated with a greater morbidity and mortality [1] and [2]. Over the last years, the role of an increased central venous pressure (CVP) during acute decompensated heart failure (ADHF) in determining worsening renal function (WRF) has been well defined [3], but only few data about its role in chronic patients are available [4]. We sought to better define the predictors of a worsening renal function in a group of outpatients affected by chronic HF (CHF) in stable clinical conditions, focusing on non-invasive parameters reflecting right ventricular pressure. We enrolled 245 outpatients with a diagnosis of CHF (ESC criteria), with a left ventricular ejection fraction (LVEF) ≤ 45%; in stable clinical conditions from at least 30 days; in conventional medical and electrical therapy; and who completed 12-month follow-up. The protocol was approved by the local ethics committee and all the enrolled patients gave their informed consent to take part. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [5]. At baseline the presence of ischemic heart disease, arterial hypertension and diabetes mellitus was recorded. NYHA class and arterial pressure were evaluated.