What question did this study set out to answer?

To determine whether tissue Doppler-derived left ventricular filling pressure provides incremental prognostic value for mortality beyond standard echocardiographic and clinical variables in patients with end-stage renal disease.

May 13, 2008HypertensionOpen Access

Left Ventricular Filling Pressure by Doppler Echocardiography in Patients With End-Stage Renal Disease

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Why the study?

Does the E/Em ratio predict all-cause mortality and cardiovascular death in patients with end-stage renal disease?

Population

220 patients with end-stage renal disease

Design

Cohort

Follow-up

median 48 months

Authors

AWAngela Yee‐Moon WangRutgers, The State University of New Jersey MWMei WangTianjin University of Sport CLChristopher Wai Kei LamUniversity of Nevada, Las Vegas

Discussion

Member takes

Implication

E/Em ratio may aid mortality risk stratification in ESRD; leaves open whether it guides therapy or improves outcomes.

Key Points

To determine whether tissue Doppler-derived left ventricular filling pressure provides incremental prognostic value for mortality beyond standard echocardiographic and clinical variables in patients with end-stage renal disease.
Assessed left ventricular filling pressure using the early mitral inflow velocity to peak mitral annulus velocity (E/Em) ratio measured by tissue Doppler imaging in 220 patients with end-stage renal disease.
Tracked patients across a median follow-up of 48 months to assess all-cause mortality and cardiovascular death using multivariable Cox regression models.
An elevated E/Em ratio (>15) was present in 62% of patients and correlated most strongly with left ventricular volume index, followed by loss of residual glomerular filtration rate, age, ejection fraction, and diabetes.
The E/Em ratio independently predicted all-cause mortality (adjusted HR: 1.027; 95% CI: 1.003 to 1.051; P=0.026) and cardiovascular death (adjusted HR: 1.033; 95% CI: 1.002 to 1.065; P=0.035).
Adding the E/Em ratio provided significant incremental prognostic value for both all-cause mortality (P=0.035) and cardiovascular death (P=0.035) beyond standard clinical, biochemical, dialysis, and conventional echocardiographic parameters.

Structured PICO

Does the E/Em ratio predict all-cause mortality and cardiovascular death in patients with end-stage renal disease?

Population

220 patients with end-stage renal disease

Intervention

Measurement of early mitral inflow velocity to peak mitral annulus velocity (E/Em) ratio by tissue Doppler imaging

Outcome

All-cause mortality and cardiovascular death at median 48 months follow-uphard clinical

Cite This Study

Wang et al. (2008) studied this question.

synapsesocial.com/papers/69fd7ebfff27123c9a5e234a https://doi.org/10.1161/hypertensionaha.108.112334

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Left Ventricular Filling Pressure by Doppler Echocardiography in Patients With End-Stage Renal Disease

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Left Ventricular Filling Pressure by Doppler Echocardiography in Patients With End-Stage Renal Disease

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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