Cardiorenal interaction: experimental and clinical studies

PhD ceremony: Mr. M.K. Szymanski, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Cardiorenal interaction: experimental and clinical studies

Promotor(s): prof. H.L. Hillege, prof. W.H. van Gilst

Faculty: Medical Sciences

Heart failure is a complex clinical syndrome characterized by impaired cardiac function and increased venous congestion. Heart failure is often associated with dysfunction of other organs including the kidneys. Impaired renal failure in the heart failure population increases the risk of mortality and hospitalizations. Conversely, cardiac dysfunction develops more frequently in patients with renal failure and leads to further deterioration of renal function. This interaction between the heart and kidneys, where malfunctioning of one of the two leads to decreased function of the other, is called the cardio-renal syndrome.

The purpose of this thesis was to explore different aspects of the pathophysiology of the cardio-renal syndrome in both experimental and clinical setting. First, animal models were surveyed which are available for experimental studies on the interaction between the heart and kidneys. In addition, animal models of combined cardiac and renal failure, which could be a tool for the experimental investigation of the cardio-renal interaction, are described. Furthermore, new possibilities for imaging the heart and kidneys in animal models using micro-PET with 13N-NH3 as a tracer were investigated. The possibilities for measuring the left ventricular parameters are described and the regional renal perfusion in rats while using this method. Lastly, the prognostic role of renin and prorenine in heart failure patients treated with RAAS inhibitors was investigated.