Inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: a retrospective study
Abstract Background Chronic kidney disease (CKD) carries the highest population attributable risk for mortality among all comorbidities in chronic heart failure (CHF). No studies about the association between inferior vena cava (IVC) diameter and all-cause mortality in patients with the comorbidity...
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BMC
2025-01-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-024-02264-x |
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| author | Jianan Li Chi Wang Hui wu Dong Jing Qi Chongyou Rao Qiuyang Li Kunlun He |
| author_facet | Jianan Li Chi Wang Hui wu Dong Jing Qi Chongyou Rao Qiuyang Li Kunlun He |
| author_sort | Jianan Li |
| collection | DOAJ |
| description | Abstract Background Chronic kidney disease (CKD) carries the highest population attributable risk for mortality among all comorbidities in chronic heart failure (CHF). No studies about the association between inferior vena cava (IVC) diameter and all-cause mortality in patients with the comorbidity of CKD and CHF has been published. Methods In this retrospective cohort study, a total of 1327 patients with CHF and CKD were included. All patients underwent standardized echocardiography examination and data on demographic characteristics, medical history, and laboratory tests were recorded. Information on all-cause mortality was collected by telephone interview and medical records review. We used Cox regression to evaluate the risk of all-cause mortality among groups, and used mediation analysis to examine the mediation role of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) and serum albumin in the association between IVC and all-cause mortality. Results During a median follow-up of 3.46 years (IQR: 1.55–5.15 years), 757 (57.05%) cases of all-cause mortality were observed. Compared with patients with IVC diameter < 21 mm, those with IVC diameter > 21 mm were associated with higher risk of all-cause mortality (HR (95%CI):1.31(1.07–1.61), log rank: P = 0.01) and cardiovascular mortality (HR (95%CI): 1.55(1.19–2.04), log rank: P = 0.001). When assessing IVC as a continuous variable, each 1% increase in IVC was associated with 4% increased risk of all-cause mortality (HR: 1.04, 95%CI 1.02–1.06, P < 0.001). This association were mediated by log NT-proBNP (mediated effect: 37.8% (95%CI 22.0–73.0%), P < 0.001) and serum albumin (mediated effect: 14.1% (95%CI 6.2–28.0%), P < 0.001). In subgroup analyses, there was no significant interaction in different subgroups of cardiac and renal function for the association between IVC and all-cause mortality. Conclusions Elevated IVC diameter was associated with worse prognosis in patients with CHF and CKD, and the associations were mediated by log NT-proBNP and serum albumin. |
| format | Article |
| id | doaj-art-02c4dfa4197b43f19be874a11e4a6955 |
| institution | Kabale University |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | European Journal of Medical Research |
| spelling | doaj-art-02c4dfa4197b43f19be874a11e4a69552025-01-19T12:14:54ZengBMCEuropean Journal of Medical Research2047-783X2025-01-0130111010.1186/s40001-024-02264-xInferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: a retrospective studyJianan Li0Chi Wang1Hui wu Dong2Jing Qi3Chongyou Rao4Qiuyang Li5Kunlun He6Medical Big Data Research Center, Medical Innovation Research Division, Chinese PLA General HospitalNational Engineering Laboratory for Industrial Big-data Application TechnologyDepartment of Ultrasound Diagnosis, The First Medical Center of Chinese, PLA General HospitalMedical Big Data Research Center, Medical Innovation Research Division, Chinese PLA General HospitalMedical Big Data Research Center, Medical Innovation Research Division, Chinese PLA General HospitalDepartment of Ultrasound Diagnosis, The First Medical Center of Chinese, PLA General HospitalMedical Big Data Research Center, Medical Innovation Research Division, Chinese PLA General HospitalAbstract Background Chronic kidney disease (CKD) carries the highest population attributable risk for mortality among all comorbidities in chronic heart failure (CHF). No studies about the association between inferior vena cava (IVC) diameter and all-cause mortality in patients with the comorbidity of CKD and CHF has been published. Methods In this retrospective cohort study, a total of 1327 patients with CHF and CKD were included. All patients underwent standardized echocardiography examination and data on demographic characteristics, medical history, and laboratory tests were recorded. Information on all-cause mortality was collected by telephone interview and medical records review. We used Cox regression to evaluate the risk of all-cause mortality among groups, and used mediation analysis to examine the mediation role of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) and serum albumin in the association between IVC and all-cause mortality. Results During a median follow-up of 3.46 years (IQR: 1.55–5.15 years), 757 (57.05%) cases of all-cause mortality were observed. Compared with patients with IVC diameter < 21 mm, those with IVC diameter > 21 mm were associated with higher risk of all-cause mortality (HR (95%CI):1.31(1.07–1.61), log rank: P = 0.01) and cardiovascular mortality (HR (95%CI): 1.55(1.19–2.04), log rank: P = 0.001). When assessing IVC as a continuous variable, each 1% increase in IVC was associated with 4% increased risk of all-cause mortality (HR: 1.04, 95%CI 1.02–1.06, P < 0.001). This association were mediated by log NT-proBNP (mediated effect: 37.8% (95%CI 22.0–73.0%), P < 0.001) and serum albumin (mediated effect: 14.1% (95%CI 6.2–28.0%), P < 0.001). In subgroup analyses, there was no significant interaction in different subgroups of cardiac and renal function for the association between IVC and all-cause mortality. Conclusions Elevated IVC diameter was associated with worse prognosis in patients with CHF and CKD, and the associations were mediated by log NT-proBNP and serum albumin.https://doi.org/10.1186/s40001-024-02264-xIVC diameterCHFCKDMortality |
| spellingShingle | Jianan Li Chi Wang Hui wu Dong Jing Qi Chongyou Rao Qiuyang Li Kunlun He Inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: a retrospective study European Journal of Medical Research IVC diameter CHF CKD Mortality |
| title | Inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: a retrospective study |
| title_full | Inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: a retrospective study |
| title_fullStr | Inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: a retrospective study |
| title_full_unstemmed | Inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: a retrospective study |
| title_short | Inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: a retrospective study |
| title_sort | inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease a retrospective study |
| topic | IVC diameter CHF CKD Mortality |
| url | https://doi.org/10.1186/s40001-024-02264-x |
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