Increased indexed proximal aortic diameter is a predictor of poor prognosis in maintenance hemodialysis patients
Background Recent studies have shown that the baseline values of absolute aortic root diameter (ARD) and indexed diameter are associated with all-cause mortality and cardiovascular events in the general population, even in the absence of aneurysmal aortic disease. However, there is limited available...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2355352 |
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| author | Junwei Xu Wenyi Tang Lizheng Song Yuxi Huang Li Xiao Fangyuan Cheng Qianglin Guan Mei Xu Chuoxin Ma Jian Chen Jianting Ke |
| author_facet | Junwei Xu Wenyi Tang Lizheng Song Yuxi Huang Li Xiao Fangyuan Cheng Qianglin Guan Mei Xu Chuoxin Ma Jian Chen Jianting Ke |
| author_sort | Junwei Xu |
| collection | DOAJ |
| description | Background Recent studies have shown that the baseline values of absolute aortic root diameter (ARD) and indexed diameter are associated with all-cause mortality and cardiovascular events in the general population, even in the absence of aneurysmal aortic disease. However, there is limited available data on the association between ARD and prognosis in end-stage renal disease (ESRD) patients receiving maintenance hemodialysis (MHD). Accordingly, the purpose of this study is to investigate the predictive value of ARD for all-cause mortality and cardiovascular events in this specific population.Methods ARD was measured by echocardiography at the level of the sinuses of Valsalva at end diastole and indexed to body surface area (BSA). The primary endpoint was all-cause mortality. The secondary endpoint was major adverse cardiovascular events (MACE), including cardiovascular mortality, myocardial infarction and stroke. Cox proportional hazards models were conducted to evaluate the association between baseline ARD/BSA and clinical outcomes.Results A total of 391 patients were included in this study. The primary endpoint occurred in 95 (24.3%) patients while the secondary endpoint occurred in 71 (18.2%) patients. Multivariate Cox regression analysis showed that ARD/BSA was an independent prognostic factor for all-cause mortality (HR, per 1-SD increase, 1.403; 95% CI, 1.118–1.761; p = 0.003) as well as MACE (HR, per 1-SD increase, 1.356; 95% CI, 1.037–1.772; p = 0.026).Conclusions Our results show that ARD/BSA is predictive of all-cause mortality and MACE in MHD patients with ESRD and support the view that assessment of ARD/BSA may refine risk stratification and preventive strategies in this population. |
| format | Article |
| id | doaj-art-e9d7119774d84fe9b450e98b6a6a6f15 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-e9d7119774d84fe9b450e98b6a6a6f152025-01-23T04:17:48ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2024.2355352Increased indexed proximal aortic diameter is a predictor of poor prognosis in maintenance hemodialysis patientsJunwei Xu0Wenyi Tang1Lizheng Song2Yuxi Huang3Li Xiao4Fangyuan Cheng5Qianglin Guan6Mei Xu7Chuoxin Ma8Jian Chen9Jianting Ke10Department of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaGuangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, BNU-HKBU United International College, ChinaDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaDepartment of Nephrology, Fifth Affiliated Hospital of Sun Yat-sen University, ChinaBackground Recent studies have shown that the baseline values of absolute aortic root diameter (ARD) and indexed diameter are associated with all-cause mortality and cardiovascular events in the general population, even in the absence of aneurysmal aortic disease. However, there is limited available data on the association between ARD and prognosis in end-stage renal disease (ESRD) patients receiving maintenance hemodialysis (MHD). Accordingly, the purpose of this study is to investigate the predictive value of ARD for all-cause mortality and cardiovascular events in this specific population.Methods ARD was measured by echocardiography at the level of the sinuses of Valsalva at end diastole and indexed to body surface area (BSA). The primary endpoint was all-cause mortality. The secondary endpoint was major adverse cardiovascular events (MACE), including cardiovascular mortality, myocardial infarction and stroke. Cox proportional hazards models were conducted to evaluate the association between baseline ARD/BSA and clinical outcomes.Results A total of 391 patients were included in this study. The primary endpoint occurred in 95 (24.3%) patients while the secondary endpoint occurred in 71 (18.2%) patients. Multivariate Cox regression analysis showed that ARD/BSA was an independent prognostic factor for all-cause mortality (HR, per 1-SD increase, 1.403; 95% CI, 1.118–1.761; p = 0.003) as well as MACE (HR, per 1-SD increase, 1.356; 95% CI, 1.037–1.772; p = 0.026).Conclusions Our results show that ARD/BSA is predictive of all-cause mortality and MACE in MHD patients with ESRD and support the view that assessment of ARD/BSA may refine risk stratification and preventive strategies in this population.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2355352Aortic root diameterend-stage renal diseasemaintenance hemodialysisall-cause mortalitymajor adverse cardiovascular eventsechocardiography |
| spellingShingle | Junwei Xu Wenyi Tang Lizheng Song Yuxi Huang Li Xiao Fangyuan Cheng Qianglin Guan Mei Xu Chuoxin Ma Jian Chen Jianting Ke Increased indexed proximal aortic diameter is a predictor of poor prognosis in maintenance hemodialysis patients Renal Failure Aortic root diameter end-stage renal disease maintenance hemodialysis all-cause mortality major adverse cardiovascular events echocardiography |
| title | Increased indexed proximal aortic diameter is a predictor of poor prognosis in maintenance hemodialysis patients |
| title_full | Increased indexed proximal aortic diameter is a predictor of poor prognosis in maintenance hemodialysis patients |
| title_fullStr | Increased indexed proximal aortic diameter is a predictor of poor prognosis in maintenance hemodialysis patients |
| title_full_unstemmed | Increased indexed proximal aortic diameter is a predictor of poor prognosis in maintenance hemodialysis patients |
| title_short | Increased indexed proximal aortic diameter is a predictor of poor prognosis in maintenance hemodialysis patients |
| title_sort | increased indexed proximal aortic diameter is a predictor of poor prognosis in maintenance hemodialysis patients |
| topic | Aortic root diameter end-stage renal disease maintenance hemodialysis all-cause mortality major adverse cardiovascular events echocardiography |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2355352 |
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