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Inferior vena cava collapsibility index, renal dysfunction, and adverse outcomes in patients with broad spectrum cardiovascular disease
Author(s) -
Kim YongHyun,
Kim Sunwon,
Kim JinSeok,
Lim SangYup,
Shim WanJoo,
Ahn JeongCheon,
Song WooHyuk
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13409
Subject(s) - medicine , cardiology , inferior vena cava , disease , broad spectrum , index (typography) , chemistry , world wide web , computer science , combinatorial chemistry
Aims The clinical implication of the inferior vena cava collapsibility index ( IVCCI ) has not been well evaluated in patients with various cardiovascular diseases. Method and results The relationships between clinical characteristics and echocardiographic indicators of the systemic intravascular volume status [ IVCCI ; the ratio of the early transmitral and early myocardial diastolic velocities (E/Em)] were evaluated at baseline, and the clinical status during follow‐up was compared across the IVCCI levels. Among 1166 patients (mean age=63.8±13.4 years), 934, 171, and 61 had high (≥50%), intermediate (25%–50%), and low (<25%) IVCCI s, respectively. Age‐, sex‐, and body mass index‐adjusted serum creatinine ( sC r) levels were highest in patients with low IVCCI ( P =.002) and E/Em >15 ( P <.001). During follow‐up (1108±463 days), 67 patients died, and 38 of these deaths were cardiovascular related. Age, body mass index, heart failure ( HF ), sC r levels, and a low IVCCI (vs high IVCCI : hazard ratio [ HR ]=3.193, 95% confidence interval [ CI ]=1.297–7.857, P =.012) were associated with all‐cause mortality in multivariable analysis. HF , diuretic use, and a low IVCCI (vs high IVCCI : HR =4.428, 95% CI =1.406–13.104, P =.007) were significantly associated with cardiovascular mortality. Conclusion A low IVCCI was significantly associated with reduced renal function and was an independent risk factor for adverse outcomes, regardless of underlying cardiovascular disease and renal function.