Left atrial volume is an independent predictor of mortality in CAPD patients

Seung Jun Kim, SeungHyeok Han, Jung Tak Park, Jwa Kyung Kim, Hyung Jung Oh, Dong Eun Yoo, TaeHyun Yoo, Shin-Wook Kang, Kyu Hun Choi

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background. Echocardiography is an established technique to estimate the risk for cardiovascular complications in patients with end-stage renal disease (ESRD). An enlarged left atrium (LA) has recently emerged as a marker of adverse cardiovascular outcomes in various pathologic conditions. However, there have been few studies to evaluate its prognostic value in patients with ESRD, particularly those receiving continuous ambulatory peritoneal dialysis (CAPD).Methods. We conducted an observational cohort study to investigate whether enlarged LA can predict patient outcome in 216 patients with CAPD. Study outcomes were all-cause and cardiovascular mortality.Results. Increased left atrium volume index (LAVI > 32 mL/m 2) was observed in 99 (45.8%) of the CAPD patients. During the follow-up (26.3 ± 18.6 months), 20 patients (9.3%) died. Kaplan-Meier analysis revealed that the 5-year survival rate was significantly lower in patients with LAVI > 32 mL/m 2 than those with LAVI ≤ 32 mL/m 2 (69 versus 82%, P = 0.024). In multivariate analyses adjusted for echocardiographic parameters and clinical and laboratory data, increased LAVI was an independent predictor of all-cause mortality [hazard ratio (HR) 1.05, 95% confidence interval (CI) 1.01-1.10, P = 0.03] and cardiovascular mortality (HR 1.08, 95% CI 1.02-1.14, P = 0.006). Furthermore, increased LAVI provided the highest predictive value for all-cause mortality [area under the receiver operating characteristic curve (AUC) = 0.766, P < 0.001] and cardiovascular mortality (AUC = 0.836, P < 0.001) among the measured echocardiographic parameters.Conclusions. We showed that increased LAVI predicted adverse outcomes better than other echocardiographic parameters in patients with CAPD.

Original languageEnglish
Pages (from-to)3732-3739
Number of pages8
JournalNephrology Dialysis Transplantation
Volume26
Issue number11
DOIs
Publication statusPublished - 2011 Nov 1

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Continuous Ambulatory Peritoneal Dialysis
Mortality
Heart Atria
Chronic Kidney Failure
Area Under Curve
Confidence Intervals
Kaplan-Meier Estimate
ROC Curve
Observational Studies
Echocardiography
Cohort Studies
Multivariate Analysis
Survival Rate
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Kim, S. J., Han, S., Park, J. T., Kim, J. K., Oh, H. J., Yoo, D. E., ... Choi, K. H. (2011). Left atrial volume is an independent predictor of mortality in CAPD patients. Nephrology Dialysis Transplantation, 26(11), 3732-3739. https://doi.org/10.1093/ndt/gfr118
Kim, Seung Jun ; Han, SeungHyeok ; Park, Jung Tak ; Kim, Jwa Kyung ; Oh, Hyung Jung ; Yoo, Dong Eun ; Yoo, TaeHyun ; Kang, Shin-Wook ; Choi, Kyu Hun. / Left atrial volume is an independent predictor of mortality in CAPD patients. In: Nephrology Dialysis Transplantation. 2011 ; Vol. 26, No. 11. pp. 3732-3739.
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abstract = "Background. Echocardiography is an established technique to estimate the risk for cardiovascular complications in patients with end-stage renal disease (ESRD). An enlarged left atrium (LA) has recently emerged as a marker of adverse cardiovascular outcomes in various pathologic conditions. However, there have been few studies to evaluate its prognostic value in patients with ESRD, particularly those receiving continuous ambulatory peritoneal dialysis (CAPD).Methods. We conducted an observational cohort study to investigate whether enlarged LA can predict patient outcome in 216 patients with CAPD. Study outcomes were all-cause and cardiovascular mortality.Results. Increased left atrium volume index (LAVI > 32 mL/m 2) was observed in 99 (45.8{\%}) of the CAPD patients. During the follow-up (26.3 ± 18.6 months), 20 patients (9.3{\%}) died. Kaplan-Meier analysis revealed that the 5-year survival rate was significantly lower in patients with LAVI > 32 mL/m 2 than those with LAVI ≤ 32 mL/m 2 (69 versus 82{\%}, P = 0.024). In multivariate analyses adjusted for echocardiographic parameters and clinical and laboratory data, increased LAVI was an independent predictor of all-cause mortality [hazard ratio (HR) 1.05, 95{\%} confidence interval (CI) 1.01-1.10, P = 0.03] and cardiovascular mortality (HR 1.08, 95{\%} CI 1.02-1.14, P = 0.006). Furthermore, increased LAVI provided the highest predictive value for all-cause mortality [area under the receiver operating characteristic curve (AUC) = 0.766, P < 0.001] and cardiovascular mortality (AUC = 0.836, P < 0.001) among the measured echocardiographic parameters.Conclusions. We showed that increased LAVI predicted adverse outcomes better than other echocardiographic parameters in patients with CAPD.",
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Left atrial volume is an independent predictor of mortality in CAPD patients. / Kim, Seung Jun; Han, SeungHyeok; Park, Jung Tak; Kim, Jwa Kyung; Oh, Hyung Jung; Yoo, Dong Eun; Yoo, TaeHyun; Kang, Shin-Wook; Choi, Kyu Hun.

In: Nephrology Dialysis Transplantation, Vol. 26, No. 11, 01.11.2011, p. 3732-3739.

Research output: Contribution to journalArticle

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T1 - Left atrial volume is an independent predictor of mortality in CAPD patients

AU - Kim, Seung Jun

AU - Han, SeungHyeok

AU - Park, Jung Tak

AU - Kim, Jwa Kyung

AU - Oh, Hyung Jung

AU - Yoo, Dong Eun

AU - Yoo, TaeHyun

AU - Kang, Shin-Wook

AU - Choi, Kyu Hun

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N2 - Background. Echocardiography is an established technique to estimate the risk for cardiovascular complications in patients with end-stage renal disease (ESRD). An enlarged left atrium (LA) has recently emerged as a marker of adverse cardiovascular outcomes in various pathologic conditions. However, there have been few studies to evaluate its prognostic value in patients with ESRD, particularly those receiving continuous ambulatory peritoneal dialysis (CAPD).Methods. We conducted an observational cohort study to investigate whether enlarged LA can predict patient outcome in 216 patients with CAPD. Study outcomes were all-cause and cardiovascular mortality.Results. Increased left atrium volume index (LAVI > 32 mL/m 2) was observed in 99 (45.8%) of the CAPD patients. During the follow-up (26.3 ± 18.6 months), 20 patients (9.3%) died. Kaplan-Meier analysis revealed that the 5-year survival rate was significantly lower in patients with LAVI > 32 mL/m 2 than those with LAVI ≤ 32 mL/m 2 (69 versus 82%, P = 0.024). In multivariate analyses adjusted for echocardiographic parameters and clinical and laboratory data, increased LAVI was an independent predictor of all-cause mortality [hazard ratio (HR) 1.05, 95% confidence interval (CI) 1.01-1.10, P = 0.03] and cardiovascular mortality (HR 1.08, 95% CI 1.02-1.14, P = 0.006). Furthermore, increased LAVI provided the highest predictive value for all-cause mortality [area under the receiver operating characteristic curve (AUC) = 0.766, P < 0.001] and cardiovascular mortality (AUC = 0.836, P < 0.001) among the measured echocardiographic parameters.Conclusions. We showed that increased LAVI predicted adverse outcomes better than other echocardiographic parameters in patients with CAPD.

AB - Background. Echocardiography is an established technique to estimate the risk for cardiovascular complications in patients with end-stage renal disease (ESRD). An enlarged left atrium (LA) has recently emerged as a marker of adverse cardiovascular outcomes in various pathologic conditions. However, there have been few studies to evaluate its prognostic value in patients with ESRD, particularly those receiving continuous ambulatory peritoneal dialysis (CAPD).Methods. We conducted an observational cohort study to investigate whether enlarged LA can predict patient outcome in 216 patients with CAPD. Study outcomes were all-cause and cardiovascular mortality.Results. Increased left atrium volume index (LAVI > 32 mL/m 2) was observed in 99 (45.8%) of the CAPD patients. During the follow-up (26.3 ± 18.6 months), 20 patients (9.3%) died. Kaplan-Meier analysis revealed that the 5-year survival rate was significantly lower in patients with LAVI > 32 mL/m 2 than those with LAVI ≤ 32 mL/m 2 (69 versus 82%, P = 0.024). In multivariate analyses adjusted for echocardiographic parameters and clinical and laboratory data, increased LAVI was an independent predictor of all-cause mortality [hazard ratio (HR) 1.05, 95% confidence interval (CI) 1.01-1.10, P = 0.03] and cardiovascular mortality (HR 1.08, 95% CI 1.02-1.14, P = 0.006). Furthermore, increased LAVI provided the highest predictive value for all-cause mortality [area under the receiver operating characteristic curve (AUC) = 0.766, P < 0.001] and cardiovascular mortality (AUC = 0.836, P < 0.001) among the measured echocardiographic parameters.Conclusions. We showed that increased LAVI predicted adverse outcomes better than other echocardiographic parameters in patients with CAPD.

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