What is the clinical evidence from this study?

Study design: Cohort. Population: Heart Failure (n=304). Intervention: Time-to-peak of renal blood flow (TTPr) via Tc-99m DTPA renal scintigraphy vs. Conventional predictors (MAGGIC score or Base model). Primary outcome: All-cause mortality (C-index 0.733, 95% CI 0.671-0.785, p=<0.001).

What question did this study set out to answer?

This research aims to determine whether the time-to-peak of renal blood flow can predict outcomes in heart failure compared to conventional predictors.

March 28, 2026Balkan Medical Journal0 citationsOpen Access

Association of Time-to-Peak of Renal Blood Flow with Outcomes in Heart Failure: An Exploratory Comparative Analysis with Conventional Predictors

Q: What are the key findings of this study?

Time-to-peak of renal blood flow significantly improved the predictive accuracy of the MAGGIC score for long-term all-cause mortality in heart failure patients, increasing the C-index by 0.040.

Q: What question did this study set out to answer?

This research aims to determine whether the time-to-peak of renal blood flow can predict outcomes in heart failure compared to conventional predictors.

YLYue LiHebei Medical University ZYZhiqiang YangHebei Medical University PYPei YinHebei Medical University

Key Result

Time-to-peak of renal blood flow significantly improved the predictive accuracy of the MAGGIC score for long-term all-cause mortality in heart failure patients, increasing the C-index by 0.040.

Key Points

This research aims to determine whether the time-to-peak of renal blood flow can predict outcomes in heart failure compared to conventional predictors.
Conducted a prospective cohort analysis of heart failure patients
Measured time-to-peak of renal blood flow as a key variable
Compared outcomes with conventional predictors of heart failure
Time-to-peak of renal blood flow was significantly associated with long-term outcomes in the cohort
Demonstrated potential incremental value over traditional predictors
Validation in larger populations is necessary before clinical use

Study Design

Type

Cohort (n=304)

Multicenter

Structured PICO

Does prolonged time-to-peak of renal blood flow (TTPr) predict mortality in patients with heart failure?

Population

Adults with heart failure (LVEF < 45% or LVEF ≥ 45% with elevated BNP and structural/diastolic dysfunction), excluding severe renal insufficiency (GFR < 30 mL/min/1.73 m²), median age 59, 69.4% male

Intervention

Time-to-peak of renal blood flow (TTPr) assessment via Tc-99m DTPA renal scintigraphy

Outcome

All-cause mortalityhard clinical

Time-to-peak of renal blood flow (TTPr) assessed by renal scintigraphy is an independent predictor of long-term mortality in heart failure patients, providing incremental prognostic value over traditional risk models.

Main Result

Effect estimate: C-index 0.733 (95% CI 0.671-0.785)

p-value: p=<0.001

Limitations

Retrospective, single-center design
Exclusion of patients with GFR < 30 mL/min/1.73 m² limits generalizability to advanced chronic kidney disease
Small sample size and low short-term event rate
Lack of established reference ranges and widespread standardization for TTPr measurements
Potential optimism bias from deriving and applying prognostic cut-offs within the same cohort
Cardiovascular mortality analysis did not account for competing risks
Practical limitations of renal scintigraphy including cost, availability, and radiation exposure

Abstract

Time-to-peak of renal blood predicted long-term outcomes in this HF cohort, showing potential incremental value. Prospective validation in broader populations is warranted before clinical implementation.

问 AI

Bookmark

View Full Paper