Key result
A low inferior vena cava collapsibility index (<25%) was independently associated with increased all-cause mortality compared to a high index (≥50%) (HR 3.193; 95% CI 1.297-7.857; P=.012).
Why the study?
Does a low inferior vena cava collapsibility index predict adverse outcomes in patients with broad spectrum cardiovascular disease?
Cohort (n=1,166)
Does a low inferior vena cava collapsibility index predict adverse outcomes in patients with broad spectrum cardiovascular disease?
A low inferior vena cava collapsibility index (<25%) is an independent echocardiographic predictor of reduced renal function and increased all-cause and cardiovascular mortality in patients with cardiovascular disease.
May aid risk stratification in cardiovascular disease; hypothesis-generating and should not yet change practice.
AIMS: The clinical implication of the inferior vena cava collapsibility index (IVCCI) has not been well evaluated in patients with various cardiovascular diseases. METHOD AND RESULTS: The relationships between clinical characteristics and echocardiographic indicators of the systemic intravascular volume status [IVCCI; the ratio of the early transmitral and early myocardial diastolic velocities (E/Em)] were evaluated at baseline, and the clinical status during follow-up was compared across the IVCCI levels. Among 1166 patients (mean age=63.8±13.4 years), 934, 171, and 61 had high (≥50%), intermediate (25%-50%), and low (<25%) IVCCIs, respectively. Age-, sex-, and body mass index-adjusted serum creatinine (sCr) levels were highest in patients with low IVCCI (P=.002) and E/Em >15 (P<.001). During follow-up (1108±463 days), 67 patients died, and 38 of these deaths were cardiovascular related. Age, body mass index, heart failure (HF), sCr levels, and a low IVCCI (vs high IVCCI: hazard ratio [HR]=3.193, 95% confidence interval [CI]=1.297-7.857, P=.012) were associated with all-cause mortality in multivariable analysis. HF, diuretic use, and a low IVCCI (vs high IVCCI: HR=4.428, 95% CI=1.406-13.104, P=.007) were significantly associated with cardiovascular mortality. CONCLUSION: A low IVCCI was significantly associated with reduced renal function and was an independent risk factor for adverse outcomes, regardless of underlying cardiovascular disease and renal function.
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Kim et al. (2016) conducted a cohort in broad spectrum cardiovascular disease (n=1,166). Low inferior vena cava collapsibility index (<25%) vs. High inferior vena cava collapsibility index (≥50%) was evaluated on all-cause mortality (HR 3.193, 95% CI 1.297-7.857, p=.012). A low inferior vena cava collapsibility index (<25%) was independently associated with increased all-cause mortality compared to a high index (≥50%) (HR 3.193; 95% CI 1.297-7.857; P=.012).
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