Assessment of Renal Hemodynamic Effects of Nesiritide in Patients With Heart Failure Using Intravascular Doppler and Quantitative Angiography
Uri Elkayam, MD, FACC*,
Mohamed W. Akhter, MD,
Ming Liu, MD,
Parta Hatamizadeh, MD,
Mohamad N. Barakat, MD
Division of Cardiology, Department of Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California
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Figure 1 Example of Renal Artery Blood Flow Velocity Measured by Intravascular Doppler Technique
Renal blood flow velocity as measured with a Doppler Flowire (Volcano Therapeutics) at baseline (A) and during nesiritide infusion (B).
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Figure 3 Mean Values of RAD and VTI
Mean group values of renal artery diameter (RAD) and velocity time integral (VTI) at baseline (BL) and at 15 min of nesiritide infusion (IN) at a dose of 0.01 µg/kg/min after intravenous bolus administration of 2 µg/kg. Continuous infusion of nesiritide was associated with a progressive significant dilation of the RAD (6.2 ± 0.7 mm to 6.7 ± 0.8 mm, p < 0.001), but at the same time a significant fall in VTI (27 ± 6 cm to 23 ± 15 cm, p < 0.001).
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Figure 4 Effect of Nesiritide on RBF
Individual values of renal blood flow (RBF) in ml/min at baseline (orange) and at 15 min of nesiritide infusion (brown) in the 15 patients studied. Mean values were 631 ± 336 ml/min at baseline and 647 ± 412 ml/min during the infusion (p = 0.15).
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