Effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis: a retrospective cohort study
Abstract Background Cardiovascular disease (CVD) is a major complication in patients on maintenance hemodialysis (MHD). While the effect of left ventricular dysfunction on patients on MHD is well known, the association between right ventricular (RV) dysfunction and their prognosis remains poorly und...
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| Language: | English |
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BMC
2025-01-01
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| Series: | Renal Replacement Therapy |
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| Online Access: | https://doi.org/10.1186/s41100-024-00602-7 |
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| author | Hiroki Nobayashi Harui Bamba Tomomichi Iida Ryuji Aoyagi Yukio Maruyama Takashi Yokoo |
| author_facet | Hiroki Nobayashi Harui Bamba Tomomichi Iida Ryuji Aoyagi Yukio Maruyama Takashi Yokoo |
| author_sort | Hiroki Nobayashi |
| collection | DOAJ |
| description | Abstract Background Cardiovascular disease (CVD) is a major complication in patients on maintenance hemodialysis (MHD). While the effect of left ventricular dysfunction on patients on MHD is well known, the association between right ventricular (RV) dysfunction and their prognosis remains poorly understood. Methods We conducted a retrospective cohort study of 149 patients on MHD (median age, 72 years; male, 67%) between 1 April 2022 and 31 March 2024. All subjects underwent transthoracic two-dimensional and Doppler echocardiographic examination. RV dysfunction was determined when the tricuspid annular plane systolic excursion (TAPSE) was under 16 mm. Kaplan–Meier survival analysis was used to compare survival between patients with and without RV dysfunction. Multivariate Cox regression analyses were used to estimate the effects of RV dysfunction on all-cause mortality, including the effect of confounding factors such as age, sex, previous CVD events, and left ventricular (LV) dysfunction. Results In total, 20 out of 149 patients on MHD (13%) had RV dysfunction. Indexes of their LV function (such as the LV ejection fraction and E/e' ratio) were similar to those of patients without RV dysfunction. During the follow-up period, 23 patients died (7 with RV dysfunction [without LV dysfunction], 3 with LV dysfunction [without RV dysfunction], 2 with biventricular dysfunction, and 11 without any ventricular dysfunction). Kaplan–Meier analyses showed significantly lower survival among patients with RV dysfunction (p < 0.01). The multivariate Cox regression analysis revealed that RV dysfunction (without LV dysfunction) was independently associated with all-cause mortality (hazard ratio: 3.44; 95% confidence interval: 1.28–9.23) after adjusting for confounders. Conclusions RV dysfunction is a significant risk factor for all-cause mortality among patients on MHD. |
| format | Article |
| id | doaj-art-98e304f4e94940fe834114fc3d9be574 |
| institution | Kabale University |
| issn | 2059-1381 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Renal Replacement Therapy |
| spelling | doaj-art-98e304f4e94940fe834114fc3d9be5742025-01-05T12:47:11ZengBMCRenal Replacement Therapy2059-13812025-01-011111710.1186/s41100-024-00602-7Effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis: a retrospective cohort studyHiroki Nobayashi0Harui Bamba1Tomomichi Iida2Ryuji Aoyagi3Yukio Maruyama4Takashi Yokoo5Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of MedicineDivision of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of MedicineDivision of Nephrology, Tachikawa General HospitalDivision of Nephrology, Tachikawa General HospitalDivision of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of MedicineDivision of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of MedicineAbstract Background Cardiovascular disease (CVD) is a major complication in patients on maintenance hemodialysis (MHD). While the effect of left ventricular dysfunction on patients on MHD is well known, the association between right ventricular (RV) dysfunction and their prognosis remains poorly understood. Methods We conducted a retrospective cohort study of 149 patients on MHD (median age, 72 years; male, 67%) between 1 April 2022 and 31 March 2024. All subjects underwent transthoracic two-dimensional and Doppler echocardiographic examination. RV dysfunction was determined when the tricuspid annular plane systolic excursion (TAPSE) was under 16 mm. Kaplan–Meier survival analysis was used to compare survival between patients with and without RV dysfunction. Multivariate Cox regression analyses were used to estimate the effects of RV dysfunction on all-cause mortality, including the effect of confounding factors such as age, sex, previous CVD events, and left ventricular (LV) dysfunction. Results In total, 20 out of 149 patients on MHD (13%) had RV dysfunction. Indexes of their LV function (such as the LV ejection fraction and E/e' ratio) were similar to those of patients without RV dysfunction. During the follow-up period, 23 patients died (7 with RV dysfunction [without LV dysfunction], 3 with LV dysfunction [without RV dysfunction], 2 with biventricular dysfunction, and 11 without any ventricular dysfunction). Kaplan–Meier analyses showed significantly lower survival among patients with RV dysfunction (p < 0.01). The multivariate Cox regression analysis revealed that RV dysfunction (without LV dysfunction) was independently associated with all-cause mortality (hazard ratio: 3.44; 95% confidence interval: 1.28–9.23) after adjusting for confounders. Conclusions RV dysfunction is a significant risk factor for all-cause mortality among patients on MHD.https://doi.org/10.1186/s41100-024-00602-7Right ventricular dysfunctionMaintenance hemodialysisTricuspid annular plane systolic excursionHeart failure |
| spellingShingle | Hiroki Nobayashi Harui Bamba Tomomichi Iida Ryuji Aoyagi Yukio Maruyama Takashi Yokoo Effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis: a retrospective cohort study Renal Replacement Therapy Right ventricular dysfunction Maintenance hemodialysis Tricuspid annular plane systolic excursion Heart failure |
| title | Effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis: a retrospective cohort study |
| title_full | Effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis: a retrospective cohort study |
| title_fullStr | Effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis: a retrospective cohort study |
| title_full_unstemmed | Effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis: a retrospective cohort study |
| title_short | Effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis: a retrospective cohort study |
| title_sort | effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis a retrospective cohort study |
| topic | Right ventricular dysfunction Maintenance hemodialysis Tricuspid annular plane systolic excursion Heart failure |
| url | https://doi.org/10.1186/s41100-024-00602-7 |
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