Parameters derived from myocardial tissue Doppler imaging associated with major events in patients with uremia

Shih Hung Hsiao, Shih Kai Lin, Wei Chen Huang, Chiu Yen Lee, Shu Hsin Yang, Kuan Rau Chiou, Chun Peng Liu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: High cardiovascular mortality in uremic patients is still a problem. This study was designed to assess some echocardiographic parameters to predict prognosis. Methods: We enrolled 95 patients (19 with coronary arterial disease). All underwent conventional echocardiography and tissue Doppler imaging within 30 minutes before and after hemodialysis (H/D). We measured the ratio of the early-diastolic velocity of mitral inflow (E) to the early-diastolic velocity of the mitral annulus (Em). Patients received 4-year follow-up for major events (any-cause mortality and nonfatal cardiovascular events requiring hospitalization). Results: Thirteen deaths and 11 nonfatal major events occurred. The prevalence of underlying coronary arterial disease was higher in patients with major events than in others (33% vs. 7%), as was the degree of left ventricular (LV) systolic dysfunction (LV ejection fraction 46% ± 10 vs. 52% ± 8). Baseline E/Em, either pre-dialytic or post-dialytic, was significantly lower in event-free patients (pre-dialytic 9.9 ± 3.0 vs. 12.2 ± 4.0, p = 0.01; post-dialytic 9.2 ± 2.9 vs. 12.3 ± 3.6, p = 0.002). On Cox regression, factors significantly affecting outcomes were age, LV ejection fraction, LV mass index (hazard ratio [HR] = 1.021, 95% confidence interval [CI] 1.001-1.039, p = 0.021), and post-dialytic E/Em ≥12 (HR = 3.054, 95% CI 1.118-11.184, p = 0.009). Conclusion: Like LV dysfunction and LV mass index, a high post-dialytic E/Em was prognostic of major events.

Original languageEnglish
Pages (from-to)254-262
Number of pages9
JournalActa Cardiologica Sinica
Volume23
Issue number4
Publication statusPublished - Dec 1 2007
Externally publishedYes

Fingerprint

Uremia
Left Ventricular Dysfunction
Stroke Volume
Coronary Disease
Confidence Intervals
Mortality
Doppler Echocardiography
Renal Dialysis
Hospitalization

Keywords

  • Cardiovascular mortality
  • Echocardiography
  • Tissue Doppler imaging
  • Uremia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hsiao, S. H., Lin, S. K., Huang, W. C., Lee, C. Y., Yang, S. H., Chiou, K. R., & Liu, C. P. (2007). Parameters derived from myocardial tissue Doppler imaging associated with major events in patients with uremia. Acta Cardiologica Sinica, 23(4), 254-262.

Parameters derived from myocardial tissue Doppler imaging associated with major events in patients with uremia. / Hsiao, Shih Hung; Lin, Shih Kai; Huang, Wei Chen; Lee, Chiu Yen; Yang, Shu Hsin; Chiou, Kuan Rau; Liu, Chun Peng.

In: Acta Cardiologica Sinica, Vol. 23, No. 4, 01.12.2007, p. 254-262.

Research output: Contribution to journalArticle

Hsiao, SH, Lin, SK, Huang, WC, Lee, CY, Yang, SH, Chiou, KR & Liu, CP 2007, 'Parameters derived from myocardial tissue Doppler imaging associated with major events in patients with uremia', Acta Cardiologica Sinica, vol. 23, no. 4, pp. 254-262.
Hsiao, Shih Hung ; Lin, Shih Kai ; Huang, Wei Chen ; Lee, Chiu Yen ; Yang, Shu Hsin ; Chiou, Kuan Rau ; Liu, Chun Peng. / Parameters derived from myocardial tissue Doppler imaging associated with major events in patients with uremia. In: Acta Cardiologica Sinica. 2007 ; Vol. 23, No. 4. pp. 254-262.
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N2 - Background: High cardiovascular mortality in uremic patients is still a problem. This study was designed to assess some echocardiographic parameters to predict prognosis. Methods: We enrolled 95 patients (19 with coronary arterial disease). All underwent conventional echocardiography and tissue Doppler imaging within 30 minutes before and after hemodialysis (H/D). We measured the ratio of the early-diastolic velocity of mitral inflow (E) to the early-diastolic velocity of the mitral annulus (Em). Patients received 4-year follow-up for major events (any-cause mortality and nonfatal cardiovascular events requiring hospitalization). Results: Thirteen deaths and 11 nonfatal major events occurred. The prevalence of underlying coronary arterial disease was higher in patients with major events than in others (33% vs. 7%), as was the degree of left ventricular (LV) systolic dysfunction (LV ejection fraction 46% ± 10 vs. 52% ± 8). Baseline E/Em, either pre-dialytic or post-dialytic, was significantly lower in event-free patients (pre-dialytic 9.9 ± 3.0 vs. 12.2 ± 4.0, p = 0.01; post-dialytic 9.2 ± 2.9 vs. 12.3 ± 3.6, p = 0.002). On Cox regression, factors significantly affecting outcomes were age, LV ejection fraction, LV mass index (hazard ratio [HR] = 1.021, 95% confidence interval [CI] 1.001-1.039, p = 0.021), and post-dialytic E/Em ≥12 (HR = 3.054, 95% CI 1.118-11.184, p = 0.009). Conclusion: Like LV dysfunction and LV mass index, a high post-dialytic E/Em was prognostic of major events.

AB - Background: High cardiovascular mortality in uremic patients is still a problem. This study was designed to assess some echocardiographic parameters to predict prognosis. Methods: We enrolled 95 patients (19 with coronary arterial disease). All underwent conventional echocardiography and tissue Doppler imaging within 30 minutes before and after hemodialysis (H/D). We measured the ratio of the early-diastolic velocity of mitral inflow (E) to the early-diastolic velocity of the mitral annulus (Em). Patients received 4-year follow-up for major events (any-cause mortality and nonfatal cardiovascular events requiring hospitalization). Results: Thirteen deaths and 11 nonfatal major events occurred. The prevalence of underlying coronary arterial disease was higher in patients with major events than in others (33% vs. 7%), as was the degree of left ventricular (LV) systolic dysfunction (LV ejection fraction 46% ± 10 vs. 52% ± 8). Baseline E/Em, either pre-dialytic or post-dialytic, was significantly lower in event-free patients (pre-dialytic 9.9 ± 3.0 vs. 12.2 ± 4.0, p = 0.01; post-dialytic 9.2 ± 2.9 vs. 12.3 ± 3.6, p = 0.002). On Cox regression, factors significantly affecting outcomes were age, LV ejection fraction, LV mass index (hazard ratio [HR] = 1.021, 95% confidence interval [CI] 1.001-1.039, p = 0.021), and post-dialytic E/Em ≥12 (HR = 3.054, 95% CI 1.118-11.184, p = 0.009). Conclusion: Like LV dysfunction and LV mass index, a high post-dialytic E/Em was prognostic of major events.

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