{
  "abstract": "Background Although studies in the past have shown that heart failure (HF) is associated with worsening renal function, such studies were mostly retrospective analyses of registry data and included patients with heart failure of predominantly ischaemic aetiology. Hence, there is paucity of evidence in evaluating the effect of heart failure per se on renal function. We, therefore, set out to evaluate the eGFR trends in a prospective study of heart failure patients with Cardiac MRI (CMR)-proven non-ischaemic cardiomyopathy.Method We included in this analysis 411 heart failure patients with non-ischaemic cardiomyopathy, followed up for 3 years (± 2 months) and with at least 3 eGFR measurements available. CMR was performed at the time of HF diagnosis. Linear mixed model was employed to assess individual eGFR slopes, whose determinants were investigated by univariate and multivariate linear regression analyses and Mann Whitney U test. Data are presented as mean ± SD, mean and 95% CI, or number (%) as appropriate.Results The mean age of the cohort was 62±12 years with 61% male participants. The baseline eGFR was 75±15 ml/min. The distribution of the eGFR slope, computed patient-by-patient by using linear mixed models, is detailed in figure 1. Overall, the mean eGFR slope was 0.04 ml/min over 3 years, with a 95% CI ranging from -0.10 to 0.17 ml/min. The determinants of eGFR slope are listed in table 1. Multivariate linear regression analysis showed age, diabetes and female gender as independently associated with declining eGFR (P<0.01), whereas the left ventricular CMR parameters at baseline such as LV end diastolic volume, LV end systolic volume, LV ejection fraction and LV mass did not correlate with this variable. In addition, patients with acute HF admission during the follow period showed trend towards declining eGFR albeit without statistical significance [-0.37 ml/min (IQR -0.93to 0.19) vs 0.07 (IQR -0.07 to 0.21), P=0.09].Conclusion To our knowledge this is the first study evaluating eGFR trends in HF patients without ischaemic cardiomyopathy confirmed using the gold standard technique of CMR. In contrast to the published literature showing steady decline in eGFR, patients with non-ischaemic cardiomyopathy exhibit relatively stable renal function. Furthermore, the severity of heart failure at diagnosis and acute HF admissions during the follow up period did not affect the eGFR trends suggesting that factors other than HF per se could play a significant role in worsening renal function in HF.",
  "authors": [
    {
      "affiliations": [
        "Mid Yorkshire Teaching NHS Trust, Wakefield, United Kingdom"
      ],
      "name": "Charles Bowers"
    },
    {
      "affiliations": [
        "Clinical Epidemiology of Renal Diseases and Hypertension Unit, Institute of Clinical Physiology, Reggio Calabria, Italy"
      ],
      "name": "Claudia Torino"
    },
    {
      "affiliations": [
        "Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom"
      ],
      "name": "Thomas Anderton"
    },
    {
      "affiliations": [
        "Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom"
      ],
      "name": "Peter Harrison"
    },
    {
      "affiliations": [
        "Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom"
      ],
      "name": "Roshan Patel"
    },
    {
      "affiliations": [
        "Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom"
      ],
      "name": "Peter Swoboda"
    },
    {
      "affiliations": [
        "Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom",
        "Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster, United Kingdom"
      ],
      "name": "Shanmugakumar Chinnappa"
    }
  ],
  "title": "234 The effect of heart failure on renal function in patients with non-ischaemic cardiomyopathy",
  "uid": "3cb6b60f-7317-526f-a609-412a45e5c755"
}