Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Sci Rep. 2017 Mar 7;7:43825. doi: 10.1038/srep43825.
The aim of this study was to evaluate the use of renal systolic time intervals measured by electrocardiographic gated Doppler ultrasonography for predicting adverse cardiac events. This longitudinal observation study enrolled 205 patients. Renal systolic time intervals, including pre-ejection period (PEP) and ejection time (ET), and ratio of renal PEP to ET, were measured by electrocardiographic gated Doppler ultrasound. The 14 adverse cardiac events identified in this population included 9 cardiac deaths and 5 hospitalizations for heart failure during an average follow up of 30.9 months (25-75 percentile: 30-33 months). Renal PEP (hazard ratio = 1.023, P = 0.001), renal ET (hazard ratio = 0.975, P = 0.001) and renal PEP/ET (per 0.01 unit increase, hazard ratio = 1.060, P < 0.001) were associated with poor cardiac outcomes. The addition of renal PEP/ET to a Cox model containing important clinical variables and renal resistive index further improved the value in predicting adverse cardiac events (Chi-square increase, 9.996; P = 0.002). This study showed that parameters of intra-renal hemodynamics were potential predictors of adverse cardiac outcomes. However, the generalizability of these indicators need to be investigated in future large-scale studies.
本研究旨在评估心电图门控多普勒超声测量的肾收缩时间间期用于预测不良心脏事件的应用。这是一项纵向观察性研究，共纳入 205 例患者。通过心电图门控多普勒超声测量肾收缩时间间期，包括射前期（PEP）和射血时间（ET），以及肾 PEP 与 ET 的比值。该人群中确定的 14 例不良心脏事件包括 9 例心脏死亡和 5 例心力衰竭住院，平均随访 30.9 个月（25-75 百分位：30-33 个月）。肾 PEP（危险比=1.023，P=0.001）、肾 ET（危险比=0.975，P=0.001）和肾 PEP/ET（每增加 0.01 单位，危险比=1.060，P<0.001）与不良心脏结局相关。将肾 PEP/ET 添加到包含重要临床变量和肾阻力指数的 Cox 模型中，进一步提高了预测不良心脏事件的价值（卡方增加，9.996；P=0.002）。本研究表明，肾内血液动力学参数可能是不良心脏结局的预测指标。然而，这些指标的泛化性需要在未来的大规模研究中进行验证。
