Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
Sci Rep. 2021 Jan 15;11(1):1559. doi: 10.1038/s41598-021-81286-5.
Acoustic cardiography can provide simultaneous electrocardiography and acoustic cardiac data to assess the electronic and mechanical heart functions. The aim of this study was to assess whether changes in acoustic cardiographic parameters (ACPs) before and after hemodialysis (HD) are associated with overall and cardiovascular (CV) mortality in HD patients. A total of 162 HD patients was enrolled and ACPs were measured before and after HD, including left ventricular systolic time (LVST), systolic dysfunction index (SDI), third (S3) and fourth (S4) heart sounds, and electromechanical activation time (EMAT). During a follow-up of 2.9 years, 25 deaths occurred with 16 from CV causes. Multivariate analysis showed that high △SDI (per 1; hazard ratio [HR], 2.178; 95% confidence interval [CI], 1.189-3.990), high △EMAT (per 1%; HR, 2.218; 95% CI 1.382-3.559), and low △LVST (per 1 ms; HR, 0.947; 95% CI 0.912-0.984) were independently associated with increased overall mortality. In addition, high △EMAT (per 1%; HR, 2.141; 95% CI 1.117-4.102), and low △LVST (per 1 ms; HR, 0.777; 95% CI 0.637-0.949) were associated with increased CV mortality. In conclusion, the changes in ACPs before and after HD may be a useful clinical marker and stronger prognostic marker of overall and CV mortality than ACPs before HD.
超声心动图可以提供同步心电图和心脏声学数据，用于评估心脏电子和机械功能。本研究旨在评估血液透析（HD）前后超声心动图参数（ACPs）的变化是否与 HD 患者的总死亡率和心血管（CV）死亡率相关。共纳入 162 例 HD 患者，在 HD 前后测量 ACPs，包括左心室收缩时间（LVST）、收缩功能指数（SDI）、第三（S3）和第四（S4）心音以及机电激活时间（EMAT）。在 2.9 年的随访中，共有 25 例患者死亡，其中 16 例死于 CV 原因。多变量分析显示，高△SDI（每增加 1；风险比[HR]，2.178；95%置信区间[CI]，1.189-3.990）、高△EMAT（每增加 1%；HR，2.218；95%CI，1.382-3.559）和低△LVST（每增加 1ms；HR，0.947；95%CI，0.912-0.984）与总死亡率增加独立相关。此外，高△EMAT（每增加 1%；HR，2.141；95%CI，1.117-4.102）和低△LVST（每增加 1ms；HR，0.777；95%CI，0.637-0.949）与 CV 死亡率增加相关。总之，HD 前后 ACPs 的变化可能是一个有用的临床标志物，比 HD 前的 ACPs 更能预测总死亡率和 CV 死亡率。
