Obokata, M and Kurosawa, K and Ishida, H and Ito, K and Ogawa, T and Ando, Y and Kurabayashi, M and Negishi, K, Incremental prognostic value of ventricular-arterial coupling over ejection fraction in patients with maintenance hemodialysis, Journal of the American Society of Echocardiography, 30, (5) pp. 444-453. ISSN 0894-7317 (2017) [Refereed Article]
Copyright 2017 by the American Society of Echocardiography.
Methods: Two hundred thirty-four hemodialysis patients were prospectively followed up for primary composite endpoint: all-cause death, nonfatal myocardial infarction, and hospitalization due to worsening heart failure (HF). Load-independent contractility (end-systolic elastance [Ees] and preload recruitable stroke work [PRSW]) and arterial afterload (arterial elastance [Ea]) were noninvasively estimated. Ventricular-arterial coupling was assessed using the Ea/Ees ratio. LV global longitudinal strain (GLS) and mitral E-wave over annular velocity E' ratio (E/E') were also measured.
Results: During a median follow-up of 776 days, 30 patients developed the primary endpoint. Ees, PRSW, GLS, S', Ea/Ees, E/E', and EF were independently associated with the outcome after adjusting for the clinical score and prior HF hospitalization, whereas end-diastolic volume index or arterial afterload parameters were not. The nested Cox models indicated that Ea/Ees had independent and incremental predictive value over the model based on the score and either EF or E/E'. Furthermore, Ea/Ees continued to have predictive value after adjusting for GLS. The classification and regression analysis stratified event rates ranging from 4.2% to 68.8%.
Conclusions: LV contractility and Ea/Ees were independently associated with adverse outcome in hemodialysis patients. Ea/Ees had an incremental prognostic value over the clinical score and EF.
|Item Type:||Refereed Article|
|Keywords:||contractility, prognosis, hemodialysis, load-independent, ventricular-arterial coupling|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Negishi, K (Dr Kazuaki Negishi)|
|Web of Science® Times Cited:||17|
|Deposited By:||Menzies Institute for Medical Research|
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