Cargando…

Cardiac Autonomic Neuropathy Predicts All-Cause and Cardiovascular Mortality in Patients With End-Stage Renal Failure: A 5-Year Prospective Study

INTRODUCTION: Chronic renal disease is associated with increased cardiovascular (CV) mortality. Cardiac autonomic neuropathy (CAN) is predictive of mortality for diseases that affect the autonomic nervous system. We prospectively evaluated the prognostic value of indexes of left ventricular (LV) fun...

Descripción completa

Detalles Bibliográficos
Autores principales: Doulgerakis, Dimitrios, Moyssakis, Ioannis, Kapelios, Chris J., Eleftheriadou, Ioanna, Chorepsima, Stamatia, Michail, Spyridon, Tentolouris, Nikolaos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678628/
https://www.ncbi.nlm.nih.gov/pubmed/29142986
http://dx.doi.org/10.1016/j.ekir.2017.03.002
_version_ 1783277477114675200
author Doulgerakis, Dimitrios
Moyssakis, Ioannis
Kapelios, Chris J.
Eleftheriadou, Ioanna
Chorepsima, Stamatia
Michail, Spyridon
Tentolouris, Nikolaos
author_facet Doulgerakis, Dimitrios
Moyssakis, Ioannis
Kapelios, Chris J.
Eleftheriadou, Ioanna
Chorepsima, Stamatia
Michail, Spyridon
Tentolouris, Nikolaos
author_sort Doulgerakis, Dimitrios
collection PubMed
description INTRODUCTION: Chronic renal disease is associated with increased cardiovascular (CV) mortality. Cardiac autonomic neuropathy (CAN) is predictive of mortality for diseases that affect the autonomic nervous system. We prospectively evaluated the prognostic value of indexes of left ventricular (LV) function and CAN in all-cause and CV mortality of patients with end-stage renal failure (ESRF). METHODS: A total of 133 patients with ESRF were recruited. LV function was evaluated by echocardiography, whereas cardiac autonomic function was assessed using the battery of the 4 standardized tests proposed by Ewing. RESULTS: A total of 123 of 133 (92.5%) patients completed the study and were followed for a mean of 4.9 ± 2.6 years. Mean LV ejection fraction (LVEF) was 50.9 ± 6.9%, whereas 70 (57.9%) patients had CAN. Sixty-nine all-cause and 36 CV deaths were recorded. The survival rates at 3, 5, and 7 years were 77.2%, 57.4%, and 33.7%, respectively. Multivariate analysis after adjustment for waist circumference, current smoking, history of diabetes, and coronary artery disease demonstrated that the only independent predictors of all-cause mortality during follow-up were age, serum triglycerides, LVEF, and presence of CAN. Competing risk regression analysis, after adjusting for waist circumference, coronary heart disease, serum glucose, and triglycerides, indicated that age and presence of CAN were independent risk factors for CV mortality. DISCUSSION: Age and presence of CAN are independent predictors of all-cause and CV mortality in patients with ESRF. The functionality of the cardiac autonomic nervous system activity can be used for the risk stratification in patients with ESRF.
format Online
Article
Text
id pubmed-5678628
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-56786282017-11-15 Cardiac Autonomic Neuropathy Predicts All-Cause and Cardiovascular Mortality in Patients With End-Stage Renal Failure: A 5-Year Prospective Study Doulgerakis, Dimitrios Moyssakis, Ioannis Kapelios, Chris J. Eleftheriadou, Ioanna Chorepsima, Stamatia Michail, Spyridon Tentolouris, Nikolaos Kidney Int Rep Clinical Research INTRODUCTION: Chronic renal disease is associated with increased cardiovascular (CV) mortality. Cardiac autonomic neuropathy (CAN) is predictive of mortality for diseases that affect the autonomic nervous system. We prospectively evaluated the prognostic value of indexes of left ventricular (LV) function and CAN in all-cause and CV mortality of patients with end-stage renal failure (ESRF). METHODS: A total of 133 patients with ESRF were recruited. LV function was evaluated by echocardiography, whereas cardiac autonomic function was assessed using the battery of the 4 standardized tests proposed by Ewing. RESULTS: A total of 123 of 133 (92.5%) patients completed the study and were followed for a mean of 4.9 ± 2.6 years. Mean LV ejection fraction (LVEF) was 50.9 ± 6.9%, whereas 70 (57.9%) patients had CAN. Sixty-nine all-cause and 36 CV deaths were recorded. The survival rates at 3, 5, and 7 years were 77.2%, 57.4%, and 33.7%, respectively. Multivariate analysis after adjustment for waist circumference, current smoking, history of diabetes, and coronary artery disease demonstrated that the only independent predictors of all-cause mortality during follow-up were age, serum triglycerides, LVEF, and presence of CAN. Competing risk regression analysis, after adjusting for waist circumference, coronary heart disease, serum glucose, and triglycerides, indicated that age and presence of CAN were independent risk factors for CV mortality. DISCUSSION: Age and presence of CAN are independent predictors of all-cause and CV mortality in patients with ESRF. The functionality of the cardiac autonomic nervous system activity can be used for the risk stratification in patients with ESRF. Elsevier 2017-03-16 /pmc/articles/PMC5678628/ /pubmed/29142986 http://dx.doi.org/10.1016/j.ekir.2017.03.002 Text en © 2017 International Society of Nephrology. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Research
Doulgerakis, Dimitrios
Moyssakis, Ioannis
Kapelios, Chris J.
Eleftheriadou, Ioanna
Chorepsima, Stamatia
Michail, Spyridon
Tentolouris, Nikolaos
Cardiac Autonomic Neuropathy Predicts All-Cause and Cardiovascular Mortality in Patients With End-Stage Renal Failure: A 5-Year Prospective Study
title Cardiac Autonomic Neuropathy Predicts All-Cause and Cardiovascular Mortality in Patients With End-Stage Renal Failure: A 5-Year Prospective Study
title_full Cardiac Autonomic Neuropathy Predicts All-Cause and Cardiovascular Mortality in Patients With End-Stage Renal Failure: A 5-Year Prospective Study
title_fullStr Cardiac Autonomic Neuropathy Predicts All-Cause and Cardiovascular Mortality in Patients With End-Stage Renal Failure: A 5-Year Prospective Study
title_full_unstemmed Cardiac Autonomic Neuropathy Predicts All-Cause and Cardiovascular Mortality in Patients With End-Stage Renal Failure: A 5-Year Prospective Study
title_short Cardiac Autonomic Neuropathy Predicts All-Cause and Cardiovascular Mortality in Patients With End-Stage Renal Failure: A 5-Year Prospective Study
title_sort cardiac autonomic neuropathy predicts all-cause and cardiovascular mortality in patients with end-stage renal failure: a 5-year prospective study
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678628/
https://www.ncbi.nlm.nih.gov/pubmed/29142986
http://dx.doi.org/10.1016/j.ekir.2017.03.002
work_keys_str_mv AT doulgerakisdimitrios cardiacautonomicneuropathypredictsallcauseandcardiovascularmortalityinpatientswithendstagerenalfailurea5yearprospectivestudy
AT moyssakisioannis cardiacautonomicneuropathypredictsallcauseandcardiovascularmortalityinpatientswithendstagerenalfailurea5yearprospectivestudy
AT kapelioschrisj cardiacautonomicneuropathypredictsallcauseandcardiovascularmortalityinpatientswithendstagerenalfailurea5yearprospectivestudy
AT eleftheriadouioanna cardiacautonomicneuropathypredictsallcauseandcardiovascularmortalityinpatientswithendstagerenalfailurea5yearprospectivestudy
AT chorepsimastamatia cardiacautonomicneuropathypredictsallcauseandcardiovascularmortalityinpatientswithendstagerenalfailurea5yearprospectivestudy
AT michailspyridon cardiacautonomicneuropathypredictsallcauseandcardiovascularmortalityinpatientswithendstagerenalfailurea5yearprospectivestudy
AT tentolourisnikolaos cardiacautonomicneuropathypredictsallcauseandcardiovascularmortalityinpatientswithendstagerenalfailurea5yearprospectivestudy