Key result
Moderate renal dysfunction independently increased the risk of cardiac events (HR 2.77) compared to normal or mildly impaired renal function in patients with nonischemic dilated cardiomyopathy.
Why the study?
Does mild to moderate renal dysfunction worsen left ventricular relaxation function and prognosis in ambulatory patients with nonischemic dilated cardiomyopathy?
Cohort (n=135)
No
Does mild to moderate renal dysfunction worsen left ventricular relaxation function and prognosis in ambulatory patients with nonischemic dilated cardiomyopathy?
In patients with nonischemic dilated cardiomyopathy, even mild renal dysfunction is associated with impaired LV relaxation, and moderate renal dysfunction independently predicts adverse cardiac events.
Answers are grounded in this paper and cite their sources.
Moderate renal dysfunction may identify higher-risk nonischemic dilated cardiomyopathy patients; hypothesis-generating and requires prospective confirmation before guiding care.
The relationship between mild-to-moderate renal dysfunction and cardiac diastolic dysfunction and cardiac events in patients with nonischemic dilated cardiomyopathy (NDCM) has not been fully elucidated. The aim of this study was to investigate the relationship between renal and cardiac function, as well as clinical outcome in patients with NDCM.We measured plasma BNP and eGFR, and performed cardiac catheterization in 135 patients with NDCM. LV dP/dtmaxand T1/2 were determined as indexes of LV contractility and isovolumic relaxation, respectively. During a mean follow-up of 4.8 years, we monitored all patients for the occurrence of cardiac events, which were defined as cardiac death (from worsening HF or sudden death) and unscheduled admission for decompensated HF. Patients were classified into 3 groups on the basis of eGFR (mL min-1 1.73 m-2): eGFR ≥ 90 (n = 23, group A), 60 ≤ eGFR < 90 (n = 70, group B), and 30 ≤ eGFR < 60 (n = 42, group C). Whereas LV dP/dtmax did not significantly differ among the 3 groups, T1/2 was significantly longer in groups B and C than in group A (P < 0.01). Event-free survival in group C was significantly lower than that in groups A and B (P = 0.014, log-rank test). These results suggest that even mild renal dysfunction is associated with LV isovolumic relaxation impairment. In addition, moderate impairment of renal function is independently associated with cardiac events in patients with NDCM.
No takes yet. Share an insight, caveat, or question.
Ohshima et al. (2011) conducted a cohort in Nonischemic Dilated Cardiomyopathy (n=135). Moderate renal dysfunction (eGFR 30-59 mL/min/1.73 m2) vs. Normal or mild renal dysfunction (eGFR ≥ 60 mL/min/1.73 m2) was evaluated on Cardiac events (cardiac death and unscheduled admission for decompensated heart failure) (HR 2.77, 95% CI 1.21-6.34, p=0.016). Moderate renal dysfunction independently increased the risk of cardiac events (HR 2.77) compared to normal or mildly impaired renal function in patients with nonischemic dilated cardiomyopathy.
Synapse has enriched 10 related papers. Consider them for comparative context: