Predictive value of echocardiographic parameters for clinical events in patients starting hemodialysis.
Echocardiographic parameters can predict cardiovascular events in several clinical settings. However, which echocardiographic parameter is most predictive of each cardiovascular or non-cardiovascular event in patients starting hemodialysis remains unresolved. Echocardiography was used in 189 patients at the time of starting hemodialysis. We established primary outcomes as follows: cardiovascular events (ischemic heart disease, cerebrovascular disease, peripheral artery disease, and acute heart failure), fatal non-cardiovascular events, all-cause mortality, and all combined events. The most predictable echocardiographic parameter was determined in the Cox hazard ratio model with a backward selection after the adjustment of multiple covariates. Among several echocardiographic parameters, the E/e' ratio and the left ventricular end-diastolic volume (LVEDV) were the strongest predictors of cardiovascular and non-cardiovascular events, respectively. After the adjustment of clinical and biochemical covariates, the predictability of E/e' remained consistent, but LVEDV did not. When clinical events were further analyzed, the significant echocardiographic parameters were as follows: s' for ischemic heart disease and peripheral artery disease, LVEDV and E/e' for acute heart failure, and E/e' for all-cause mortality and all combined events. However, no echocardiographic parameter independently predicted cerebrovascular disease or non-cardiovascular events. In conclusion, E/e', s', and LVEDV have independent predictive values for several cardiovascular and mortality events.
['Han|Seung Seok|SS|0000-0003-0137-5261', 'Cho|Goo-Yeong|GY|', 'Park|Youn Su|YS|', 'Baek|Seon Ha|SH|', 'Ahn|Shin Young|SY|', 'Kim|Sejoong|S|0000-0002-7238-9962', 'Chin|Ho Jun|HJ|0000-0003-1185-2631', 'Chae|Dong-Wan|DW|', 'Na|Ki Young|KY|0000-0002-8872-8236']
D004452:Echocardiography D005260:Female D006333:Heart Failure D006801:Humans D007676:Kidney Failure, Chronic D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D011379:Prognosis D006435:Renal Dialysis D012307:Risk Factors D016277:Ventricular Function, Left
Echocardiography Mortality Heart Failure, Diastolic Kidney Failure, Chronic Morbidity Renal Dialysis