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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
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.
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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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