Association between central venous pressure as assessed by echocardiography, left ventricular function and acute cardio-renal syndrome in patients with ST segment elevation myocardial infarction

Shafik Khoury, Arie Steinvil, Amir Gal-Oz, Gilad Margolis, Aviram Hochstatd, Yan Topilsky, Gad Keren, Yacov Shacham

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Recent reports have demonstrated the adverse effects of venous congestion on renal function in patients with heart failure. None of these trials, however, has evaluated the effect of acute myocardial ischemia on the occurrence of acute kidney injury (AKI). Methods: We conducted a retrospective study of 1336 ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) between June 2012 and June 2016. Comprehensive echocardiographic examination was performed within 72 h of hospital admission. Non-invasive evaluation of central venous pressure (CVP) was estimated from measurements of inferior vena cava diameter and its collapsibility. Intermediate-high CVP was defined as ≥ 8 mm/Hg. Patients were stratified according to left ventricular ejection fraction (LVEF) and CVP and assessed for AKI. Results: Intermediate-high CVP was associated with AKI both in patients with LVEF greater than 45% and those with 45% or lower. Patients having LVEF ≤ 45% and intermediate-high CVP had a 10-fold increase in the incidence of AKI compared to patients with LVEF > 45% and normal CVP (39 vs. 4%). In a multivariable logistic regression model, intermediate-high CVP was independently associated with AKI (OR = 2.73, 95% CI 1.54–4.87; p = 0.001). Other variables associated with AKI included LVEF ≤ 45% (OR = 2.37, 95%CI 1.25–4.51; p = 0.008), time to reperfusion, mechanical ventilation and chronic kidney disease. Conclusions: Among STEMI patients undergoing PCI, the utilization of simple echocardiographic measurements (LVEF and CVP) may be useful for early identification of those at high risk for AKI.

Original languageEnglish
Pages (from-to)937-944
Number of pages8
JournalClinical Research in Cardiology
Volume107
Issue number10
DOIs
StatePublished - 1 Oct 2018

Keywords

  • Acute kidney injury
  • Cardiorenal syndrome
  • Central venous pressure
  • ST elevation myocardial infarction

Fingerprint

Dive into the research topics of 'Association between central venous pressure as assessed by echocardiography, left ventricular function and acute cardio-renal syndrome in patients with ST segment elevation myocardial infarction'. Together they form a unique fingerprint.

Cite this