Major Events in Uremic Patients: Insight from Parameters Derived by Flow Propagation Velocity

Shih Hung Hsiao, Wei Chun Huang, Kuan R. Chiou, Chiu Y. Lee, Shu Hsin Yang, Wen Chin Wang, Shih K. Lin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The parameters derived by flow propagation velocity (FPV) of early-diastolic mitral inflow have been proved to be associated with cardiovascular risk. This study was undertaken to analyze the prognosis of uremic patients by FPV. Methods: A total of 100 uremic patients were enrolled. All patients underwent conventional echocardiographic examination and FPV measurement. Those examinations were performed before and after hemodialysis (within 30 minutes). Patients were followed for 4 years. Major events were recorded and defined as any-cause mortality and nonfatal cardiovascular events with hospitalization. Patients were separated into two groups according to a post-dialytic E/FPV of <1.5 or ≥1.5 (early-diastolic velocity of mitral inflow divided by FPV). Results: Twenty-six major events were recorded, including 13 cases with mortality and 13 cases with nonfatal cardiovascular events. The patients with a post-dialytic E/FPV of ≥1.5 had a higher prevalence of underlying coronary arterial disease (30% vs. 17%), left ventricular systolic dysfunction (left ventricular ejection fraction: 46% ± 10% vs. 52% ± 8%), and a major event. By Cox regression analysis, a post-dialytic E/FPV of ≥1.5 (hazard ratio 2.358, 95% confidence interval 1.118-4.62, P = .008) was the strongest independent factor to predict the major events, after adjustment of other covariates. Conclusion: A post-dialytic E/FPV of ≥1.5 predicts higher adverse events in uremic patients.

Original languageEnglish
Pages (from-to)741-746
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume21
Issue number6
DOIs
Publication statusPublished - Jun 1 2008
Externally publishedYes

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Mortality
Left Ventricular Dysfunction
Stroke Volume
Coronary Disease
Renal Dialysis
Hospitalization
Regression Analysis
Confidence Intervals

Keywords

  • Cardiovascular mortality
  • Echocardiography
  • Flow propagation velocity
  • Uremia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Major Events in Uremic Patients : Insight from Parameters Derived by Flow Propagation Velocity. / Hsiao, Shih Hung; Huang, Wei Chun; Chiou, Kuan R.; Lee, Chiu Y.; Yang, Shu Hsin; Wang, Wen Chin; Lin, Shih K.

In: Journal of the American Society of Echocardiography, Vol. 21, No. 6, 01.06.2008, p. 741-746.

Research output: Contribution to journalArticle

Hsiao, Shih Hung ; Huang, Wei Chun ; Chiou, Kuan R. ; Lee, Chiu Y. ; Yang, Shu Hsin ; Wang, Wen Chin ; Lin, Shih K. / Major Events in Uremic Patients : Insight from Parameters Derived by Flow Propagation Velocity. In: Journal of the American Society of Echocardiography. 2008 ; Vol. 21, No. 6. pp. 741-746.
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AB - Background: The parameters derived by flow propagation velocity (FPV) of early-diastolic mitral inflow have been proved to be associated with cardiovascular risk. This study was undertaken to analyze the prognosis of uremic patients by FPV. Methods: A total of 100 uremic patients were enrolled. All patients underwent conventional echocardiographic examination and FPV measurement. Those examinations were performed before and after hemodialysis (within 30 minutes). Patients were followed for 4 years. Major events were recorded and defined as any-cause mortality and nonfatal cardiovascular events with hospitalization. Patients were separated into two groups according to a post-dialytic E/FPV of <1.5 or ≥1.5 (early-diastolic velocity of mitral inflow divided by FPV). Results: Twenty-six major events were recorded, including 13 cases with mortality and 13 cases with nonfatal cardiovascular events. The patients with a post-dialytic E/FPV of ≥1.5 had a higher prevalence of underlying coronary arterial disease (30% vs. 17%), left ventricular systolic dysfunction (left ventricular ejection fraction: 46% ± 10% vs. 52% ± 8%), and a major event. By Cox regression analysis, a post-dialytic E/FPV of ≥1.5 (hazard ratio 2.358, 95% confidence interval 1.118-4.62, P = .008) was the strongest independent factor to predict the major events, after adjustment of other covariates. Conclusion: A post-dialytic E/FPV of ≥1.5 predicts higher adverse events in uremic patients.

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