Major events in uremic patients: insight from parameters derived by flow propagation velocity.
BACKGROUND
The parameters derived by flow propagation velocity (FPV) of early-diastolic mitral inflow have been proved to be associated with cardiovascular risk. This study was undertaken to analyze the prognosis of uremic patients by FPV.


METHODS
A total of 100 uremic patients were enrolled. All patients underwent conventional echocardiographic examination and FPV measurement. Those examinations were performed before and after hemodialysis (within 30 minutes). Patients were followed for 4 years. Major events were recorded and defined as any-cause mortality and nonfatal cardiovascular events with hospitalization. Patients were separated into two groups according to a post-dialytic E/FPV of <1.5 or > or =1.5 (early-diastolic velocity of mitral inflow divided by FPV).


RESULTS
Twenty-six major events were recorded, including 13 cases with mortality and 13 cases with nonfatal cardiovascular events. The patients with a post-dialytic E/FPV of > or =1.5 had a higher prevalence of underlying coronary arterial disease (30% vs. 17%), left ventricular systolic dysfunction (left ventricular ejection fraction: 46% +/- 10% vs. 52% +/- 8%), and a major event. By Cox regression analysis, a post-dialytic E/FPV of > or =1.5 (hazard ratio 2.358, 95% confidence interval 1.118-4.62, P = .008) was the strongest independent factor to predict the major events, after adjustment of other covariates.


CONCLUSIONS
A post-dialytic E/FPV of > or =1.5 predicts higher adverse events in uremic patients.
Hsiao
Shih-Hung
SH
Cardiovascular Center, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan, Republic of China. a841120@ms3.hinet.net
Huang
Wei-Chun
WC
Chiou
Kuan-Rau
KR
Lee
Chiu-Yen
CY
Yang
Shu-Hsin
SH
Wang
Wen-Chin
WC
Lin
Shih-Kai
SK
D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D014463:Ultrasonography; D014511:Uremia / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging