Value of echocardiography in predicting heart failure and death in adult patients with chronic kidney disease
Objective To investigate the effect of echocardiography in predicting HF and death in adult patients with CKD.Methods A total of 357 CKD patients treated in the Yongmei Group General Hospital from January 2016 to June 2018 were selected.Logisitic regression analysis was applied to explore the relevant factors affecting HF and death of pa-tients.receiver operation characteristic was applied.To investigate the predictive value of echocardiographic indexes for HF and death.Results ① Age,hyperlipidemia,LVEDVI,LVIDD,LVEF,LVMI,IVSD and left ventricular geometry were the influencing factors of chronic HF in CKD patients.② Age,hypertension,hemoglobin,LVEDVI,LVIDD,LVEF,LVMI,IVSD,RWT and left ventricular geometry were the influencing factors of death in CKD patients.③ Pre-diction model of HF incidence in CKD patients=-0.203+0.051 × LVEDVI(mL/m2)+0.070 × LVIDD(mm)-0.069 × LVEF(％)+0.023 × LVMI(g/m2)+0.083 × IVSD(mm)+0.544 × Left ventricular geometry.④ Prediction model of death of CKD patients=0.101+0.063 × LVEDVI+0.076 × LVIDD-0.082 × LVEF+0.029 × LVMI+0.087 × IVSD+0.886 × Left ventricular geometry.⑤LVEDVI,LVIDD,LVEF,LVMI,IVSD,and left ventricular geometry alone and in combination predicted HF:ROC-AUC(0.95CI)in CKD patients as 0.682(0.360～0.985),0.702(0.390～0.989),0.700(0.471～0.918),0.674(0.399～0.950),0.683(0.402～0.950),0.695(0.459～0.929),and 0.850(0.702～0.978),respectively.⑥ LVEDVI,LVIDD,LVEF,LVMI,IVSD,RWT,and left ventricular geometry alone or in combination predicted the death of CKD patients:ROC-AUC(0.95CI)were 0.677(0.372～0.962),0.673(0.361～0.986),0.666(0.382～0.946),0.692(0.407～0.961),0.674(0.368～0.979),0.658(0.386～0.912),0.681(0.371～0.988),and 0.834(0.722～0.919),respectively.Conclusion The baseline echocardiographic parameters are independently associated with the increased risk of HF incidence rate and mortality in CKD patients,but their predictive value is low.
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