title: Subendocardial viability ratio predicts cardiovascular mortality in chronic kidney disease patients.
abstract: BACKGROUND
  The subendocardial viability ratio (SEVR), calculated by pulse wave analysis, is an index of myocardial oxygen supply and demand. Here we analyze the relation between SEVR and cardiovascular mortality in the chronic kidney disease (CKD) population of a post hoc analysis of a multicenter, prospective, randomized, nonblinded study.
  
  
  METHODS
  We studied 212 consecutive asymptomatic outpatients receiving care at 12 nephrology clinics in south Italy. Inclusion criteria were age >18 years, 6 months of follow-up before the enrollment and stage 3-4 CKD.
  
  
  RESULTS
  During follow-up, 34 subjects died, 29 of them for cardiovascular causes. SEVR correlated inversely with vascular calcifications (r = -0.37) and myocardial mass (r = -0.45); SEVR changed from 1.33 ± 0.24 to 1.36 ± 0.16 (p = NS; baseline and final values, respectively) in living patients, and from 1.16 ± 0.31 to 0.68 ± 0.26 in deceased patients (p < 0.001). Kaplan-Meier curves show that that a greater reduction of SEVR values during the study (third tertile) significantly predicts cardiovascular mortality (p < 0.0001).
  
  
  CONCLUSIONS
  This post hoc analysis shows that a reduction of SEVR values impacts cardiovascular mortality in CKD patients.
authors.affiliation: Division of Nephrology, A. Landolfi Hospital, Solofra, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Di Micco
authors.forename: P
authors.initials: P
authors.lastname: Salvi
authors.forename: A
authors.initials: A
authors.lastname: Bellasi
authors.forename: M L
authors.initials: ML
authors.lastname: Sirico
authors.forename: B
authors.initials: B
authors.lastname: Di Iorio
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D051436:Renal Insufficiency, Chronic / Q000150:complications*