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Coronary sinus diameter to estimate congestion and predict survival
BACKGROUND: Congestion predicts a poor prognosis, but its assessment is challenging in clinical practice and requires a multiparametric approach. We investigated if the coronary sinus (CS) diameter can predict mortality in a human model of rapid fluid unloading. METHODS: We measured by echocardiogra...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10663896/ https://www.ncbi.nlm.nih.gov/pubmed/38020054 http://dx.doi.org/10.1016/j.ijcha.2023.101294 |
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author | Barchitta, Agatella Rossitto, Giacomo Ruzza, Luisa Maio, Daniele Scaparotta, Giuseppe Bagordo, Domenico Antonini Canterin, Francesco Piovesana, Piergiuseppe Seccia, Teresa Maria Nalesso, Federico Calò, Lorenzo Rossi, Gian Paolo |
author_facet | Barchitta, Agatella Rossitto, Giacomo Ruzza, Luisa Maio, Daniele Scaparotta, Giuseppe Bagordo, Domenico Antonini Canterin, Francesco Piovesana, Piergiuseppe Seccia, Teresa Maria Nalesso, Federico Calò, Lorenzo Rossi, Gian Paolo |
author_sort | Barchitta, Agatella |
collection | PubMed |
description | BACKGROUND: Congestion predicts a poor prognosis, but its assessment is challenging in clinical practice and requires a multiparametric approach. We investigated if the coronary sinus (CS) diameter can predict mortality in a human model of rapid fluid unloading. METHODS: We measured by echocardiography the CS, and the inferior vena cava (IVC) for comparison, in 60 patients with end-stage chronic kidney disease (ESKD) immediately before and after hemodialysis (HD; age 76 [57–81] years, 40% female, left ventricular ejection fraction 57 [53–56]%). Patients were prospectively followed up for all-cause mortality. RESULTS: HD-induced decongestion decreased the maximum diameters of both CS and IVC (p ≤ 0.001 for all). The maximum diameter of the CS (CS(max)) was as accurate as the IVC maximum diameter and collapsibility for the identification of congestion, defined as pre-hemodialysis status (AUROC CS(max) = 0.902 vs IVC = 0.895, p = n.s.). A CS(max) diameter after hemodialysis > 9 mm predicted all-cause mortality at 12 months (Log-rank Chi square = 11.49, p < 0.001). CONCLUSIONS: A persistently dilated CS after hemodialysis is a marker of residual congestion and predicts death at one year in high-risk ESKD patients. |
format | Online Article Text |
id | pubmed-10663896 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-106638962023-11-08 Coronary sinus diameter to estimate congestion and predict survival Barchitta, Agatella Rossitto, Giacomo Ruzza, Luisa Maio, Daniele Scaparotta, Giuseppe Bagordo, Domenico Antonini Canterin, Francesco Piovesana, Piergiuseppe Seccia, Teresa Maria Nalesso, Federico Calò, Lorenzo Rossi, Gian Paolo Int J Cardiol Heart Vasc Original Paper BACKGROUND: Congestion predicts a poor prognosis, but its assessment is challenging in clinical practice and requires a multiparametric approach. We investigated if the coronary sinus (CS) diameter can predict mortality in a human model of rapid fluid unloading. METHODS: We measured by echocardiography the CS, and the inferior vena cava (IVC) for comparison, in 60 patients with end-stage chronic kidney disease (ESKD) immediately before and after hemodialysis (HD; age 76 [57–81] years, 40% female, left ventricular ejection fraction 57 [53–56]%). Patients were prospectively followed up for all-cause mortality. RESULTS: HD-induced decongestion decreased the maximum diameters of both CS and IVC (p ≤ 0.001 for all). The maximum diameter of the CS (CS(max)) was as accurate as the IVC maximum diameter and collapsibility for the identification of congestion, defined as pre-hemodialysis status (AUROC CS(max) = 0.902 vs IVC = 0.895, p = n.s.). A CS(max) diameter after hemodialysis > 9 mm predicted all-cause mortality at 12 months (Log-rank Chi square = 11.49, p < 0.001). CONCLUSIONS: A persistently dilated CS after hemodialysis is a marker of residual congestion and predicts death at one year in high-risk ESKD patients. Elsevier 2023-11-08 /pmc/articles/PMC10663896/ /pubmed/38020054 http://dx.doi.org/10.1016/j.ijcha.2023.101294 Text en © 2023 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Original Paper Barchitta, Agatella Rossitto, Giacomo Ruzza, Luisa Maio, Daniele Scaparotta, Giuseppe Bagordo, Domenico Antonini Canterin, Francesco Piovesana, Piergiuseppe Seccia, Teresa Maria Nalesso, Federico Calò, Lorenzo Rossi, Gian Paolo Coronary sinus diameter to estimate congestion and predict survival |
title | Coronary sinus diameter to estimate congestion and predict survival |
title_full | Coronary sinus diameter to estimate congestion and predict survival |
title_fullStr | Coronary sinus diameter to estimate congestion and predict survival |
title_full_unstemmed | Coronary sinus diameter to estimate congestion and predict survival |
title_short | Coronary sinus diameter to estimate congestion and predict survival |
title_sort | coronary sinus diameter to estimate congestion and predict survival |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10663896/ https://www.ncbi.nlm.nih.gov/pubmed/38020054 http://dx.doi.org/10.1016/j.ijcha.2023.101294 |
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