Right ventricular dysfunction is associated with chronic kidney disease and predicts survival in patients with chronic systolic heart failure
| Autor: | Francesca Donati, Anca Simioniuc, Paolo C. Colombo, Doralisa Morrone, Paolo Caravelli, Ryan T. Demmer, Giacinta Guarini, Frank Lloyd Dini, Enrico Orsini, Mario Marzilli |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Ventricular Dysfunction Right Statistics as Topic Renal function urologic and male genital diseases Ventricular Function Left Risk Factors Internal medicine Outpatients Confidence Intervals Odds Ratio medicine Humans In patient Aged Analysis of Variance business.industry Chronic systolic heart failure Stroke Volume Odds ratio Stroke volume Middle Aged Prognosis medicine.disease United States female genital diseases and pregnancy complications Right ventricular dysfunction Echocardiography Heart failure Cardiology Kidney Failure Chronic Female Cardiology and Cardiovascular Medicine business Glomerular Filtration Rate Heart Failure Systolic Kidney disease |
| Popis: | Chronic kidney disease (CKD) and right ventricular (RV) dysfunction are important predictors of prognosis in heart failure (HF). We investigated the relationship between RV dysfunction and CKD in outpatients with chronic systolic HF, an association which remains poorly defined.Outpatients (n = 373) with chronic HF and left ventricular ejection fraction (LVEF) ≤45% underwent clinical and echo-Doppler evaluations and were followed up for 31 ± 24 months. Tricuspid annular plane systolic excursion (TAPSE) assessed RV dysfunction. The estimated glomerular filtration rate (GFR) was measured by the simplified Modification of Diet in Renal Disease (MDRD) formula. Correlation analysis was used to characterize the association between TAPSE and estimated GFR. Odds ratios (ORs) for CKD and hazard ratios (HRs) for all-cause mortality were assessed using multivariable logistic or proportional hazards regression models. TAPSE and estimated GFR were significantly correlated (r = 0.38, P0.0001). TAPSE ≤14 mm was associated with elevated estimated right atrial pressure and N-terminal pro brain natriuretic peptide levels. TAPSE ≤14 mm increased the odds of estimated GFR60 mL/min/1.73 m(2), OR [95% confidence interval (CI)] = 2.51(1.44-4.39), P0.0001 and predicted all-cause mortality, HR (95% CI) = 1.80 (1.20-2.71) after multivariable adjustment.Right ventricular dysfunction is cross-sectionally associated with CKD and prospectively predicts survival in outpatients with chronic systolic HF. These data suggest RV dysfunction to be one of the possible mechanistic links between HF and CKD. |
| Databáze: | OpenAIRE |
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