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Incremental prognostic value of ventricular-arterial coupling over ejection fraction in patients with maintenance hemodialysis
Citation
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 Statement
Copyright 2017 by the American Society of Echocardiography.
DOI: doi:10.1016/j.echo.2016.12.014
Abstract
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 Details
Item Type: | Refereed Article |
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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 Division: | Health |
Objective Group: | Clinical health |
Objective Field: | Clinical health not elsewhere classified |
UTAS Author: | Negishi, K (Dr Kazuaki Negishi) |
ID Code: | 114686 |
Year Published: | 2017 |
Web of Science® Times Cited: | 17 |
Deposited By: | Menzies Institute for Medical Research |
Deposited On: | 2017-02-23 |
Last Modified: | 2022-08-25 |
Downloads: | 0 |
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