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Article: Left ventricular filling pressure by doppler echocardiography in patients with end-stage renal disease

TitleLeft ventricular filling pressure by doppler echocardiography in patients with end-stage renal disease
Authors
KeywordsEnd-stage renal disease
Left ventricular filling pressure
Mortality risk
Tissue Doppler
Issue Date2008
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://hyper.ahajournals.org/
Citation
Hypertension, 2008, v. 52 n. 1, p. 107-114 How to Cite?
AbstractLeft ventricular hypertrophy and systolic dysfunction predict mortality in patients with end-stage renal disease. However, the prognostic value of left ventricular filling pressure has remained uncertain in this population. We evaluated whether the early mitral inflow velocity to peak mitral annulus velocity (E/Em) ratio, an estimate of left ventricular filling pressure by tissue Doppler imaging, has significant additional prognostic value to conventional echocardiographic parameters and other clinical and biochemical parameters in 220 patients with end-stage renal disease. The E/Em ratio was elevated (>15) in 62% of the patients. Multivariate analysis showed that an elevated E/Em ratio had the highest correlation with left ventricular volume index, followed by loss of residual glomerular filtration rate, increasing age, worsening ejection fraction, and diabetes. During the median follow-up of 48 months, the E/Em ratio emerged as an independent predictor of all-cause mortality (adjusted hazard ratio: 1.027; 95% CI: 1.003 to 1.051; P=0.026) and cardiovascular death (adjusted hazard ratio: 1.033; 95% CI: 1.002 to 1.065; P=0.035) in the multivariable Cox regression analysis. In addition, the E/Em ratio added significant incremental prognostic value for all-cause mortality (P=0.035) and cardiovascular death (P=0.035) beyond the standard clinical, biochemical, and dialysis parameters and echocardiographic measurements. In conclusion, the E/Em ratio displayed important additional long-term prognostic information above and beyond that of left ventricular mass and systolic function. Our data suggest that left ventricular filling pressure should be estimated during echocardiographic examination for additional prognostication in patients with end-stage renal disease. © 2008 American Heart Association, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/78560
ISSN
2015 Impact Factor: 6.294
2015 SCImago Journal Rankings: 3.702
ISI Accession Number ID
Funding AgencyGrant Number
Hong Kong Health Service Research6901023
Funding Information:

This study was supported by the Hong Kong Health Service Research Fund (project code 6901023), of which A.Y-M.W. was the principal investigator.

References

 

DC FieldValueLanguage
dc.contributor.authorWang, AYMen_HK
dc.contributor.authorWang, Men_HK
dc.contributor.authorLam, CWKen_HK
dc.contributor.authorChan, IHSen_HK
dc.contributor.authorZhang, Yen_HK
dc.contributor.authorSanderson, JEen_HK
dc.date.accessioned2010-09-06T07:44:14Z-
dc.date.available2010-09-06T07:44:14Z-
dc.date.issued2008en_HK
dc.identifier.citationHypertension, 2008, v. 52 n. 1, p. 107-114en_HK
dc.identifier.issn0194-911Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/78560-
dc.description.abstractLeft ventricular hypertrophy and systolic dysfunction predict mortality in patients with end-stage renal disease. However, the prognostic value of left ventricular filling pressure has remained uncertain in this population. We evaluated whether the early mitral inflow velocity to peak mitral annulus velocity (E/Em) ratio, an estimate of left ventricular filling pressure by tissue Doppler imaging, has significant additional prognostic value to conventional echocardiographic parameters and other clinical and biochemical parameters in 220 patients with end-stage renal disease. The E/Em ratio was elevated (>15) in 62% of the patients. Multivariate analysis showed that an elevated E/Em ratio had the highest correlation with left ventricular volume index, followed by loss of residual glomerular filtration rate, increasing age, worsening ejection fraction, and diabetes. During the median follow-up of 48 months, the E/Em ratio emerged as an independent predictor of all-cause mortality (adjusted hazard ratio: 1.027; 95% CI: 1.003 to 1.051; P=0.026) and cardiovascular death (adjusted hazard ratio: 1.033; 95% CI: 1.002 to 1.065; P=0.035) in the multivariable Cox regression analysis. In addition, the E/Em ratio added significant incremental prognostic value for all-cause mortality (P=0.035) and cardiovascular death (P=0.035) beyond the standard clinical, biochemical, and dialysis parameters and echocardiographic measurements. In conclusion, the E/Em ratio displayed important additional long-term prognostic information above and beyond that of left ventricular mass and systolic function. Our data suggest that left ventricular filling pressure should be estimated during echocardiographic examination for additional prognostication in patients with end-stage renal disease. © 2008 American Heart Association, Inc.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://hyper.ahajournals.org/en_HK
dc.relation.ispartofHypertensionen_HK
dc.subjectEnd-stage renal diseaseen_HK
dc.subjectLeft ventricular filling pressureen_HK
dc.subjectMortality risken_HK
dc.subjectTissue Doppleren_HK
dc.titleLeft ventricular filling pressure by doppler echocardiography in patients with end-stage renal diseaseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0143-117X&volume=52&issue=1&spage=107&epage=114&date=2008&atitle=Left+ventricular+filling+pressure+by+Doppler+echocardiography+in+patients+with+end-stage+renal+disease.+en_HK
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_HK
dc.identifier.authorityWang, M=rp00281en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1161/HYPERTENSIONAHA.108.112334en_HK
dc.identifier.pmid18474835-
dc.identifier.scopuseid_2-s2.0-46449136719en_HK
dc.identifier.hkuros155819en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-46449136719&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume52en_HK
dc.identifier.issue1en_HK
dc.identifier.spage107en_HK
dc.identifier.epage114en_HK
dc.identifier.isiWOS:000256880000017-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWang, AYM=13606226000en_HK
dc.identifier.scopusauthoridWang, M=7406690398en_HK
dc.identifier.scopusauthoridLam, CWK=8531362100en_HK
dc.identifier.scopusauthoridChan, IHS=8298775100en_HK
dc.identifier.scopusauthoridZhang, Y=7601312580en_HK
dc.identifier.scopusauthoridSanderson, JE=7202371250en_HK

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