A new systolic parameter defined as the ratio of brachial pre-ejection period to brachial ejection time predicts overall and cardiovascular mortality in hemodialysis patients.
Impaired left ventricular systolic function is an important cause of mortality in hemodialysis patients. An increase in the ratio of pre-ejection period (PEP) to ejection time (ET) is associated with a decrease in left ventricular systolic function. Brachial PEP (bPEP) and brachial ET (bET) can be automatically determined from an ankle-brachial index (ABI)-form device. The aim of this study was to investigate whether bPEP/bET was a useful predictor for overall and cardiovascular mortality in hemodialysis patients. We enrolled 212 hemodialysis patients in one regional hospital. The bPEP and bET were measured using an ABI-form device. The mean follow-up period was 28.3+/-5.7 months. The relative mortality risk was analyzed by Cox-regression methods. Twenty-two deaths were recorded in 212 patients (10.4%). In a multivariate analysis, the bPEP/bET (hazard ratio [HR], 1.055; P=0.047) and serum creatinine level (P=0.029) were positively and negatively associated with overall mortality, respectively. In addition, increased bPEP/bET (HR, 1.080; P=0.017), increased fasting glucose (P=0.046) and decreased serum creatinine level (P=0.004) were independent predictors for cardiovascular mortality. Our findings show that bPEP/bET, a surrogate of left ventricular systolic function, is a useful predictor for overall and cardiovascular mortality in hemodialysis patients. Screening hemodialysis patients by means of bPEP/bET may help to identify a high-risk group for increased mortality.
Chen
Szu-Chia
SC
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Chang
Jer-Ming
JM
Tsai
Jer-Chia
JC
Hsu
Po-Chao
PC
Lin
Tsung-Hsien
TH
Su
Ho-Ming
HM
Voon
Wen-Chol
WC
Hwang
Shang-Jyh
SJ
Chen
Hung-Chun
HC
D000328:Adult; D000368:Aged; D001916:Brachial Artery / Q000503:physiopathology*; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000401:mortality*; D012306:Risk; D018570:Risk Assessment; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000401:mortality*
D003404:Creatinine