Association between elevated echocardiographic index of left ventricular filling pressure and acute kidney injury after off-pump coronary artery surgery

Min Hur, Karam Nam, Woo Young Jo, Gahyun Kim, Won Ho Kim, Jae-Hyon Bahk

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The ratio of the early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e′) is an echocardiographic index of mean left ventricular (LV) filling pressure. We investigated the association between the preoperative E/e′ ratio and postoperative acute kidney injury (AKI) during off-pump coronary artery bypass surgery (OPCAB). Methods and Results: We reviewed 585 patients who underwent OPCAB and with preserved LV ejection fraction determined by preoperative echocardiography. AKI was determined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression analysis was performed. E/e′ was also analyzed as 3 categories (E/e′ <8, 8≤E/e′≤15, and E/e′ >15) and as a continuous variable. A propensity score analysis was used to match the patients with E/e′ >15 and E/e′ ≤15. A preoperative E/e′ >15 was an independent predictor for AKI (odds ratio 3.01, 95% confidence interval 1.40–6.17). E/e′ >15 was also an independent predictor for AKI when E/e′ was analyzed with 3 categories or as a continuous variable. In the matched sample, the incidence of AKI and 1-year mortality was significantly higher in patients with E/e′ >15. Conclusions: Among patients undergoing OPCAB with preserved LV systolic function, a preoperative E/e′ ratio >15 was an independent predictor of postoperative AKI. Measurement of the preoperative E/e′ ratio may help to assess the risk of postoperative AKI.

Original languageEnglish
Pages (from-to)857-865
Number of pages9
JournalCirculation Journal
Volume82
Issue number3
DOIs
StatePublished - 1 Jan 2018

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Ventricular Pressure
Acute Kidney Injury
Coronary Vessels
Off-Pump Coronary Artery Bypass
Coronary Artery Bypass
Propensity Score
Kidney Diseases
Left Ventricular Function
Stroke Volume
Echocardiography
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals
Mortality
Incidence

Keywords

  • Acute kidney injury
  • Coronary artery bypass grafting
  • Diastolic dysfunction
  • Echocardiography

Cite this

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title = "Association between elevated echocardiographic index of left ventricular filling pressure and acute kidney injury after off-pump coronary artery surgery",
abstract = "Background: The ratio of the early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e′) is an echocardiographic index of mean left ventricular (LV) filling pressure. We investigated the association between the preoperative E/e′ ratio and postoperative acute kidney injury (AKI) during off-pump coronary artery bypass surgery (OPCAB). Methods and Results: We reviewed 585 patients who underwent OPCAB and with preserved LV ejection fraction determined by preoperative echocardiography. AKI was determined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression analysis was performed. E/e′ was also analyzed as 3 categories (E/e′ <8, 8≤E/e′≤15, and E/e′ >15) and as a continuous variable. A propensity score analysis was used to match the patients with E/e′ >15 and E/e′ ≤15. A preoperative E/e′ >15 was an independent predictor for AKI (odds ratio 3.01, 95{\%} confidence interval 1.40–6.17). E/e′ >15 was also an independent predictor for AKI when E/e′ was analyzed with 3 categories or as a continuous variable. In the matched sample, the incidence of AKI and 1-year mortality was significantly higher in patients with E/e′ >15. Conclusions: Among patients undergoing OPCAB with preserved LV systolic function, a preoperative E/e′ ratio >15 was an independent predictor of postoperative AKI. Measurement of the preoperative E/e′ ratio may help to assess the risk of postoperative AKI.",
keywords = "Acute kidney injury, Coronary artery bypass grafting, Diastolic dysfunction, Echocardiography",
author = "Min Hur and Karam Nam and Jo, {Woo Young} and Gahyun Kim and Kim, {Won Ho} and Jae-Hyon Bahk",
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Association between elevated echocardiographic index of left ventricular filling pressure and acute kidney injury after off-pump coronary artery surgery. / Hur, Min; Nam, Karam; Jo, Woo Young; Kim, Gahyun; Kim, Won Ho; Bahk, Jae-Hyon.

In: Circulation Journal, Vol. 82, No. 3, 01.01.2018, p. 857-865.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between elevated echocardiographic index of left ventricular filling pressure and acute kidney injury after off-pump coronary artery surgery

AU - Hur, Min

AU - Nam, Karam

AU - Jo, Woo Young

AU - Kim, Gahyun

AU - Kim, Won Ho

AU - Bahk, Jae-Hyon

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The ratio of the early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e′) is an echocardiographic index of mean left ventricular (LV) filling pressure. We investigated the association between the preoperative E/e′ ratio and postoperative acute kidney injury (AKI) during off-pump coronary artery bypass surgery (OPCAB). Methods and Results: We reviewed 585 patients who underwent OPCAB and with preserved LV ejection fraction determined by preoperative echocardiography. AKI was determined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression analysis was performed. E/e′ was also analyzed as 3 categories (E/e′ <8, 8≤E/e′≤15, and E/e′ >15) and as a continuous variable. A propensity score analysis was used to match the patients with E/e′ >15 and E/e′ ≤15. A preoperative E/e′ >15 was an independent predictor for AKI (odds ratio 3.01, 95% confidence interval 1.40–6.17). E/e′ >15 was also an independent predictor for AKI when E/e′ was analyzed with 3 categories or as a continuous variable. In the matched sample, the incidence of AKI and 1-year mortality was significantly higher in patients with E/e′ >15. Conclusions: Among patients undergoing OPCAB with preserved LV systolic function, a preoperative E/e′ ratio >15 was an independent predictor of postoperative AKI. Measurement of the preoperative E/e′ ratio may help to assess the risk of postoperative AKI.

AB - Background: The ratio of the early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e′) is an echocardiographic index of mean left ventricular (LV) filling pressure. We investigated the association between the preoperative E/e′ ratio and postoperative acute kidney injury (AKI) during off-pump coronary artery bypass surgery (OPCAB). Methods and Results: We reviewed 585 patients who underwent OPCAB and with preserved LV ejection fraction determined by preoperative echocardiography. AKI was determined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression analysis was performed. E/e′ was also analyzed as 3 categories (E/e′ <8, 8≤E/e′≤15, and E/e′ >15) and as a continuous variable. A propensity score analysis was used to match the patients with E/e′ >15 and E/e′ ≤15. A preoperative E/e′ >15 was an independent predictor for AKI (odds ratio 3.01, 95% confidence interval 1.40–6.17). E/e′ >15 was also an independent predictor for AKI when E/e′ was analyzed with 3 categories or as a continuous variable. In the matched sample, the incidence of AKI and 1-year mortality was significantly higher in patients with E/e′ >15. Conclusions: Among patients undergoing OPCAB with preserved LV systolic function, a preoperative E/e′ ratio >15 was an independent predictor of postoperative AKI. Measurement of the preoperative E/e′ ratio may help to assess the risk of postoperative AKI.

KW - Acute kidney injury

KW - Coronary artery bypass grafting

KW - Diastolic dysfunction

KW - Echocardiography

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DO - 10.1253/circj.CJ-17-0660

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JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

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