Document Detail


Right ventricular dysfunction is associated with chronic kidney disease and predicts survival in patients with chronic systolic heart failure.
MedLine Citation:
PMID:  22357576     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: 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.
METHODS AND RESULTS: 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, P < 0.0001). 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 GFR <60 mL/min/1.73 m(2), OR [95% confidence interval (CI)] = 2.51(1.44-4.39), P < 0.0001 and predicted all-cause mortality, HR (95% CI) = 1.80 (1.20-2.71) after multivariable adjustment.
CONCLUSIONS: 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.
Authors:
Frank L Dini; Ryan T Demmer; Anca Simioniuc; Doralisa Morrone; Francesca Donati; Giacinta Guarini; Enrico Orsini; Paolo Caravelli; Mario Marzilli; Paolo C Colombo
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Validation Studies    
Journal Detail:
Title:  European journal of heart failure     Volume:  14     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-23     Completed Date:  2012-06-19     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  287-94     Citation Subset:  IM    
Affiliation:
Cardiac, Thoracic and Vascular Department, University of Pisa, Via Paradisa 2, Pisa, Italy. f.dini@ao-pisa.toscana.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Confidence Intervals
Echocardiography
Female
Glomerular Filtration Rate
Heart Failure, Systolic / mortality,  pathology*,  ultrasonography
Humans
Kidney Failure, Chronic / mortality,  pathology*,  ultrasonography
Male
Middle Aged
Odds Ratio
Outpatients
Prognosis
Risk Factors
Statistics as Topic
Stroke Volume
United States
Ventricular Dysfunction, Right / mortality,  pathology*,  ultrasonography
Ventricular Function, Left
Grant Support
ID/Acronym/Agency:
DE018739/DE/NIDCR NIH HHS; R01 HL092144/HL/NHLBI NIH HHS
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