Inferior vena cava collapsibility index, renal dysfunction, and adverse outcomes in patients with broad spectrum cardiovascular disease. Issue 1 (3rd November 2016)

• Record Type: Journal Article
• Authors: Kim, Yong‐Hyun; Kim, Sunwon; Kim, Jin‐Seok; Lim, Sang‐Yup; Shim, Wan‐Joo; Ahn, Jeong‐Cheon; Song, Woo‐Hyuk
• Is Part Of: Echocardiography. Volume 34:Issue 1(2017)
• Page Start: 20
• Page End: 28
• Publication Date: 2016-11-03
• Subjects: cardiovascular death -- heart failure -- inferior vena cava -- renal function; Echocardiography -- Periodicals; Echocardiography -- Periodicals; 616.1207543
• DOI: 10.1111/echo.13409
• Languages: English
• ISSNs: 0742-2822

Abstract

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.