Cardiothoracic Ratio and All-Cause Mortality and Cardiovascular Disease Events in Hemodialysis Patients: The Q-Cohort Study

Ryusuke Yotsueda, Masatomo Taniguchi, Shigeru Tanaka, Masahiro Eriguchi, Kiichiro Fujisaki, Kumiko Torisu, Kosuke Masutani, Hideki Hirakata, Takanari Kitazono, Kazuhiko Tsuruya

研究成果: Contribution to journalArticle査読

25 被引用数 (Scopus)

抄録

Background Cardiothoracic ratio by chest radiography is commonly used to assess volume status. Little is known about the relationships between cardiothoracic ratio and the incidence of clinical outcomes in patients undergoing hemodialysis (HD). Study Design Prospective cohort study. Setting & Participants 3,436 participants in the Q-Cohort Study 18 years or older who underwent maintenance HD in Japan. Predictor Cardiothoracic ratio. Outcomes & Measurements All-cause mortality and cardiovascular disease (CVD) events. Results During a 4-year follow-up period, 564 (16.4%) patients died of any cause and 590 (17.2%) developed CVD events. From baseline cardiothoracic ratios, participants were categorized into sex-specific quartiles because cardiothoracic ratio distribution differed by sex. The 4-year event-free survival rate, in terms of all-cause mortality and CVD events, was significantly lower with higher cardiothoracic ratios. Compared to the lowest cardiothoracic ratio (quartile 1), multivariable-adjusted HRs for all-cause mortality were 0.89 (95% CI, 0.66-1.20), 1.41 (1.08-1.86), and 1.52 (1.17-2.00) in patients from quartiles 2, 3, and 4, respectively. Similarly, in comparison to quartile 1, multivariable-adjusted HRs for CVD events were 1.00 (95% CI, 0.77-1.31), 1.18 (0.92-1.53), and 1.37 (1.07-1.76) in patients from quartiles 2, 3, and 4, respectively. Furthermore, the combination of higher cardiothoracic ratio and normohypotension (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) was associated with higher risk for CVD events. Limitations Single measurement of all variables, potentially less-heterogeneous patient population, and limited ascertainment of cardiac parameters and the outcomes. Conclusions Higher cardiothoracic ratio is associated with higher risk for both all-cause mortality and CVD events in patients undergoing HD.

本文言語英語
ページ(範囲)84-92
ページ数9
ジャーナルAmerican Journal of Kidney Diseases
70
1
DOI
出版ステータス出版済み - 7 2017

All Science Journal Classification (ASJC) codes

  • 腎臓病学

フィンガープリント

「Cardiothoracic Ratio and All-Cause Mortality and Cardiovascular Disease Events in Hemodialysis Patients: The Q-Cohort Study」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル