Background:Interruption in Doppler intrarenal venous flow (IRVF) has been used in assessing renal congestion and in the prediction of prognosis of cardiovascular diseases. However, there is a paucity of pathophysiological knowledge, so we aimed to clarify the determinants of IRVF interruption.

Methods and Results:Intrarenal Doppler studies were performed within 24 h before right-side catheterization studies. The interruption in IRVF in 73 patients was divided into a continuous pattern, and 4 discontinuous types based on the timing of interruption. Type 1, with an interruption in early systole, was associated with a-wave elevation of right atrial pressure (RAP). Type 2, with an interruption in early diastole, was associated with v-wave elevation, tricuspid regurgitation (TR), and right ventricular dysfunction. Both Type 1 and 2 were observed even in the normal range of mean RAP. Type 3, with an interruption throughout systole, was observed in advanced right heart failure patients with markedly elevated RAP, particularly elevated x-descend and atrial fibrillation. Finally, Type 4, with limited flow at systole, was observed in 2 of the patients with pulmonary arterial hypertension.

Conclusions:IRVF interruption was closely related to RAP elevation at each specific point of the cardiac cycle rather than to mean RAP levels, suggesting that the characteristics of IRVF mirror right-sided heart hemodynamics, not mean RAP.

背景：多普勒肾内静脉血流 (IRVF) 中断已被用于评估肾充血和预测心血管疾病的预后。然而，缺乏病理生理学知识，因此我们旨在阐明 IRVF 中断的决定因素。

方法和结果：在右侧导管插入术研究之前的 24 小时内进行了肾内多普勒研究。73 名患者的 IRVF 中断根据中断时间分为连续模式和 4 种不连续类型。1 型，收缩早期中断，与右心房压 (RAP) 的 a 波升高有关。2 型，舒张早期中断，与 v 波升高、三尖瓣关闭不全 (TR) 和右心室功能障碍有关。即使在平均 RAP 的正常范围内，也观察到 1 型和 2 型。在 RAP 显着升高的晚期右心衰竭患者中观察到 3 型，在整个收缩期中断，尤其是 x 下降和心房颤动。最后，类型 4，收缩期流量有限，

结论： IRVF 中断与心动周期每个特定点的 RAP 升高密切相关，而不是与平均 RAP 水平密切相关，表明 IRVF 的特征反映了右侧心脏血流动力学，而不是平均 RAP。