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Echocardiographic parameters as cardiovascular event predictors in hemodialysis patients.
MedLine Citation:
PMID:  22766916     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Patients with chronic kidney disease (CKD) on hemodialysis have high rates of cardiovascular morbidity and mortality. Although structural and functional echocardiographic alterations in patients undergoing hemodialysis have been the subject of several survival analysis studies, the prognostic value of these alterations is not well established in literature. OBJECTIVE: To determine the prognostic value of echocardiographic parameters in patients with CKD on hemodialysis. METHODS: Sixty consecutive patients with CKD on hemodialysis were clinically evaluated and underwent Doppler echocardiography, being followed for 19 ± 6 months. The outcome measures were fatal and nonfatal cardiovascular events and overall mortality. The predictive value of echocardiographic variables was evaluated by Cox regression model and survival curves were constructed using the Kaplan-Meier method and log rank test to compare them. RESULTS: Rates of survival free of cardiovascular events, of cardiovascular and overall mortality in two years were 79.4%, 88.5% and 83% respectively. Diabetes, previous diagnosis of cardiovascular disease (CVD), ejection fraction, fractional shortening, left ventricular systolic diameter and E/e' ratio were predictors of cardiovascular outcome at univariate analysis. In the multivariate analysis, previous history of CVD (HR = 6.17, 95%CI: 1.7 - 22.2, p = 0.005) and moderate to severe diastolic dysfunction (HR = 3.76, 95%CI: 1.05 - 13.4, p = 0.042) were independent risk factors for cardiovascular events. CONCLUSION: Moderate to severe diastolic dysfunction is an independent predictor of cardiovascular events in hemodialysis patients.
Authors:
Thayse Mayara Aragão Siqueira; Pedro Antônio Muniz Ferreira; Francisco das Chagas Monteiro Júnior; Natalino Salgado Filho; Adalgisa de Souza Paiva Ferreira; Eugênio Dos Santos Neto; Francival Leite de Souza; Paulo de Tarso Cardoso
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-05
Journal Detail:
Title:  Arquivos brasileiros de cardiologia     Volume:  -     ISSN:  1678-4170     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421031     Medline TA:  Arq Bras Cardiol     Country:  -    
Other Details:
Languages:  ENG; POR     Pagination:  -     Citation Subset:  -    
Affiliation:
Universidade Federal do Maranhão, São Luís, MA, Brasil.
Vernacular Title:
Parâmetros ecocardiográficos como preditores de eventos cardiovasculares em pacientes em hemodiálise.
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