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09.05.2018 | Original Paper

Association between central venous pressure as assessed by echocardiography, left ventricular function and acute cardio-renal syndrome in patients with ST segment elevation myocardial infarction

verfasst von: Shafik Khoury, Arie Steinvil, Amir Gal-Oz, Gilad Margolis, Aviram Hochstatd, Yan Topilsky, Gad Keren, Yacov Shacham

Erschienen in: Clinical Research in Cardiology | Ausgabe 10/2018

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Abstract

Background

Recent reports have demonstrated the adverse effects of venous congestion on renal function in patients with heart failure. None of these trials, however, has evaluated the effect of acute myocardial ischemia on the occurrence of acute kidney injury (AKI).

Methods

We conducted a retrospective study of 1336 ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) between June 2012 and June 2016. Comprehensive echocardiographic examination was performed within 72 h of hospital admission. Non-invasive evaluation of central venous pressure (CVP) was estimated from measurements of inferior vena cava diameter and its collapsibility. Intermediate-high CVP was defined as ≥ 8 mm/Hg. Patients were stratified according to left ventricular ejection fraction (LVEF) and CVP and assessed for AKI.

Results

Intermediate-high CVP was associated with AKI both in patients with LVEF greater than 45% and those with 45% or lower. Patients having LVEF ≤ 45% and intermediate-high CVP had a 10-fold increase in the incidence of AKI compared to patients with LVEF > 45% and normal CVP (39 vs. 4%). In a multivariable logistic regression model, intermediate-high CVP was independently associated with AKI (OR = 2.73, 95% CI 1.54–4.87; p = 0.001). Other variables associated with AKI included LVEF ≤ 45% (OR = 2.37, 95%CI 1.25–4.51; p = 0.008), time to reperfusion, mechanical ventilation and chronic kidney disease.

Conclusions

Among STEMI patients undergoing PCI, the utilization of simple echocardiographic measurements (LVEF and CVP) may be useful for early identification of those at high risk for AKI.

Shacham Y, Leshem-Rubinow E, Steinvil A, Assa EB, Keren G, Roth A, Arbel Y (2014) Renal impairment according to acute kidney injury network criteria among ST elevation myocardial infarction patients undergoing primary percutaneous intervention: a retrospective observational study. Clin Res Cardiol 103(7):525–532. https://doi.org/10.1007/s00392-014-0680-8 CrossRefPubMed

Marenzi G, Assanelli E, Campodonico J, De Metrio M, Lauri G, Marana I, Moltrasio M, Rubino M, Veglia F, Montorsi P, Bartorelli AL (2010) Acute kidney injury in ST-segment elevation acute myocardial infarction complicated by cardiogenic shock at admission. Crit Care Med 38(2):438–444. https://doi.org/10.1097/CCM.0b013e3181b9eb3b CrossRefPubMed

Goldberg A, Hammerman H, Petcherski S, Zdorovyak A, Yalonetsky S, Kapeliovich M, Agmon Y, Markiewicz W, Aronson D (2005) Inhospital and 1-year mortality of patients who develop worsening renal function following acute ST-elevation myocardial infarction. Am Heart J 150(2):330–337. https://doi.org/10.1016/j.ahj.2004.09.055 CrossRefPubMed

Parikh CR, Coca SG, Wang Y, Masoudi FA, Krumholz HM (2008) Long-term prognosis of acute kidney injury after acute myocardial infarction. Arch Intern Med 168(9):987–995. https://doi.org/10.1001/archinte.168.9.987 CrossRefPubMed

Amin AP, Spertus JA, Reid KJ, Lan X, Buchanan DM, Decker C, Masoudi FA (2010) The prognostic importance of worsening renal function during an acute myocardial infarction on long-term mortality. Am Heart J 160(6):1065–1071. https://doi.org/10.1016/j.ahj.2010.08.007 CrossRefPubMed

Shacham Y, Leshem-Rubinow E, Gal-Oz A, Arbel Y, Keren G, Roth A, Steinvil A (2015) Acute cardio-renal syndrome as a cause for renal deterioration among myocardial infarction patients treated with primary percutaneous intervention. Can J Cardiol 31(10):1240–1244. https://doi.org/10.1016/j.cjca.2015.03.031 CrossRefPubMed

Tandon R, Mohan B, Chhabra ST, Aslam N, Wander GS (2013) Clinical and echocardiographic predictors of cardiorenal syndrome type I in patients with acute ischemic right ventricular dysfunction. Cardiorenal Med 3(4):239–245. https://doi.org/10.1159/000355524 CrossRefPubMedPubMedCentral

Schroten NF, Damman K, Valente MA, Smilde TD, van Veldhuisen DJ, Navis G, Gaillard CA, Voors AA, Hillege HL (2016) Long-term changes in renal function and perfusion in heart failure patients with reduced ejection fraction. Clin Res Cardiol 105(1):10–16. https://doi.org/10.1007/s00392-015-0881-9 CrossRefPubMed

Nohria A, Hasselblad V, Stebbins A, Pauly DF, Fonarow GC, Shah M, Yancy CW, Califf RM, Stevenson LW, Hill JA (2008) Cardiorenal interactions: insights from the ESCAPE trial. J Am Coll Cardiol 51(13):1268–1274. https://doi.org/10.1016/j.jacc.2007.08.072 CrossRefPubMed

10.

Testani JM, Khera AV, St John Sutton MG, Keane MG, Wiegers SE, Shannon RP, Kirkpatrick JN (2010) Effect of right ventricular function and venous congestion on cardiorenal interactions during the treatment of decompensated heart failure. Am J Cardiol 105(4):511–516. https://doi.org/10.1016/j.amjcard.2009.10.020 CrossRefPubMedPubMedCentral

11.

Khoury S, Carmon S, Margolis G, Keren G, Shacham Y (2017) Incidence and outcomes of early left ventricular thrombus following ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. Clin Res Cardiol 106(9):695–701. https://doi.org/10.1007/s00392-017-1111-4 CrossRefPubMed

12.

Shacham Y, Leshem-Rubinow E, Gal-Oz A, Arbel Y, Keren G, Roth A, Steinvil A (2014) Relation of time to coronary reperfusion and the development of acute kidney injury after ST-segment elevation myocardial infarction. Am J Cardiol 114(8):1131–1135. https://doi.org/10.1016/j.amjcard.2014.07.032 CrossRefPubMed

13.

American College of Emergency P, Society for Cardiovascular A, Interventions, O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (2013) 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 61(4):e78–e140. https://doi.org/10.1016/j.jacc.2012.11.019 CrossRef

14.

Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF III, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J, Ckd EPI (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150(9):604–612CrossRefPubMedPubMedCentral

15.

Summary of Recommendation Statements (2012) Kidney Int Suppl (2011) 2(1):8–12. https://doi.org/10.1038/kisup.2012.7 CrossRef

16.

Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ, Chamber Quantification Writing G, American Society of Echocardiography’s G, Standards C, European Association of E (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18(12):1440–1463. https://doi.org/10.1016/j.echo.2005.10.005 CrossRefPubMed

17.

Nagueh SF, Kopelen HA, Zoghbi WA (1996) Relation of mean right atrial pressure to echocardiographic and Doppler parameters of right atrial and right ventricular function. Circulation 93(6):1160–1169CrossRefPubMed

18.

Nagueh SF, Smiseth OA, Appleton CP, Byrd BF III, Dokainish H, Edvardsen T, Flachskampf FA, Gillebert TC, Klein AL, Lancellotti P, Marino P, Oh JK, Popescu BA, Waggoner AD (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 29(4):277–314. https://doi.org/10.1016/j.echo.2016.01.011 CrossRefPubMed

19.

Flint N, Kaufman N, Gal-Oz A, Margolis G, Topilsky Y, Keren G, Shacham Y (2017) Echocardiographic correlates of left ventricular filling pressures and acute cardio-renal syndrome in ST segment elevation myocardial infarction patients. Clin Res Cardiol 106(2):120–126. https://doi.org/10.1007/s00392-016-1031-8 CrossRefPubMed

20.

Ronco C, Haapio M, House AA, Anavekar N, Bellomo R (2008) Cardiorenal syndrome. J Am Coll Cardiol 52(19):1527–1539. https://doi.org/10.1016/j.jacc.2008.07.051 CrossRefPubMed

21.

Hori M, Nishida K (2009) Oxidative stress and left ventricular remodelling after myocardial infarction. Cardiovasc Res 81(3):457–464. https://doi.org/10.1093/cvr/cvn335 CrossRefPubMed

22.

Mullens W, Abrahams Z, Francis GS, Sokos G, Taylor DO, Starling RC, Young JB, Tang WH (2009) Importance of venous congestion for worsening of renal function in advanced decompensated heart failure. J Am Coll Cardiol 53(7):589–596. https://doi.org/10.1016/j.jacc.2008.05.068 CrossRefPubMedPubMedCentral

23.

Damman K, Voors AA, Hillege HL, Navis G, Lechat P, van Veldhuisen DJ, Dargie HJ, Investigators C-, Committees (2010) Congestion in chronic systolic heart failure is related to renal dysfunction and increased mortality. Eur J Heart Fail 12(9):974–982. https://doi.org/10.1093/eurjhf/hfq118 CrossRefPubMed

24.

Maeder MT, Holst DP, Kaye DM (2008) Tricuspid regurgitation contributes to renal dysfunction in patients with heart failure. J Card Fail 14(10):824–830. https://doi.org/10.1016/j.cardfail.2008.07.236 CrossRefPubMed

25.

Hamza SM, Kaufman S (2007) Effect of mesenteric vascular congestion on reflex control of renal blood flow. Am J Physiol Regul Integr Comp Physiol 293(5):R1917–R1922. https://doi.org/10.1152/ajpregu.00180.2007 CrossRefPubMed

26.

Tanaka M, Yoshida H, Furuhashi M, Togashi N, Koyama M, Yamamoto S, Yamashita T, Okazaki Y, Ishimura S, Ota H, Hasegawa T, Miura T (2011) Deterioration of renal function by chronic heart failure is associated with congestion and oxidative stress in the tubulointerstitium. Intern Med 50(23):2877–2887CrossRefPubMed

27.

James MT, Samuel SM, Manning MA, Tonelli M, Ghali WA, Faris P, Knudtson ML, Pannu N, Hemmelgarn BR (2013) Contrast-induced acute kidney injury and risk of adverse clinical outcomes after coronary angiography: a systematic review and meta-analysis. Circ Cardiovasc Interv 6(1):37–43. https://doi.org/10.1161/CIRCINTERVENTIONS.112.974493 CrossRefPubMed

28.

Shacham Y, Gal-Oz A, Topilsky Y, Keren G, Arbel Y (2016) Relation of pulmonary artery pressure and renal impairment in ST segment elevation myocardial infarction patients. Echocardiography 33(7):956–961. https://doi.org/10.1111/echo.13206 CrossRefPubMed

29.

Coca SG, Yalavarthy R, Concato J, Parikh CR (2008) Biomarkers for the diagnosis and risk stratification of acute kidney injury: a systematic review. Kidney Int 73(9):1008–1016. https://doi.org/10.1038/sj.ki.5002729 CrossRefPubMed

30.

Koyner JL, Parikh CR (2013) Clinical utility of biomarkers of AKI in cardiac surgery and critical illness. Clin J Am Soc Nephrol 8(6):1034–1042. https://doi.org/10.2215/CJN.05150512 CrossRefPubMed

Titel: Association between central venous pressure as assessed by echocardiography, left ventricular function and acute cardio-renal syndrome in patients with ST segment elevation myocardial infarction
verfasst von: Shafik Khoury
Arie Steinvil
Amir Gal-Oz
Gilad Margolis
Aviram Hochstatd
Yan Topilsky
Gad Keren
Yacov Shacham
Publikationsdatum: 09.05.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 10/2018
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1266-7

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Association between central venous pressure as assessed by echocardiography, left ventricular function and acute cardio-renal syndrome in patients with ST segment elevation myocardial infarction

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