Inferior vena cava collapsibility index, renal dysfunction, and adverse outcomes in patients with broad spectrum cardiovascular disease

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Abstract

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%) IVCCIs, respectively. Age-, sex-, and body mass index-adjusted serum creatinine (sCr) 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), sCr 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.

Original languageEnglish
Pages (from-to)20-28
Number of pages9
JournalEchocardiography
Volume34
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Inferior Vena Cava
Cardiovascular Diseases
Kidney
Heart Failure
Confidence Intervals
Mortality
Diuretics
Body Mass Index

Keywords

  • cardiovascular death
  • heart failure
  • inferior vena cava
  • renal function

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{5e308df81ae04a92a8a81e297eaaca92,
title = "Inferior vena cava collapsibility index, renal dysfunction, and adverse outcomes in patients with broad spectrum cardiovascular disease",
abstract = "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{\%}) IVCCIs, respectively. Age-, sex-, and body mass index-adjusted serum creatinine (sCr) 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), sCr 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.",
keywords = "cardiovascular death, heart failure, inferior vena cava, renal function",
author = "Kim, {Yong Hyun} and Sunwon Kim and Jin-Seok Kim and Lim, {Sang Yeob} and Shim, {Wan Joo} and Ahn, {Jeong Cheon} and Woohyuk Song",
year = "2017",
month = "1",
day = "1",
doi = "10.1111/echo.13409",
language = "English",
volume = "34",
pages = "20--28",
journal = "Echocardiography",
issn = "0742-2822",
publisher = "Wiley-Blackwell",
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TY - JOUR

T1 - Inferior vena cava collapsibility index, renal dysfunction, and adverse outcomes in patients with broad spectrum cardiovascular disease

AU - Kim, Yong Hyun

AU - Kim, Sunwon

AU - Kim, Jin-Seok

AU - Lim, Sang Yeob

AU - Shim, Wan Joo

AU - Ahn, Jeong Cheon

AU - Song, Woohyuk

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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%) IVCCIs, respectively. Age-, sex-, and body mass index-adjusted serum creatinine (sCr) 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), sCr 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.

AB - 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%) IVCCIs, respectively. Age-, sex-, and body mass index-adjusted serum creatinine (sCr) 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), sCr 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.

KW - cardiovascular death

KW - heart failure

KW - inferior vena cava

KW - renal function

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U2 - 10.1111/echo.13409

DO - 10.1111/echo.13409

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JO - Echocardiography

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SN - 0742-2822

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