Parameters derived from myocardial tissue Doppler imaging associated with major events in patients with uremia

Shih Hung Hsiao, Shih Kai Lin, Wei Chen Huang, Chiu Yen Lee, Shu Hsin Yang, Kuan Rau Chiou, Chun Peng Liu

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: High cardiovascular mortality in uremic patients is still a problem. This study was designed to assess some echocardiographic parameters to predict prognosis. Methods: We enrolled 95 patients (19 with coronary arterial disease). All underwent conventional echocardiography and tissue Doppler imaging within 30 minutes before and after hemodialysis (H/D). We measured the ratio of the early-diastolic velocity of mitral inflow (E) to the early-diastolic velocity of the mitral annulus (Em). Patients received 4-year follow-up for major events (any-cause mortality and nonfatal cardiovascular events requiring hospitalization). Results: Thirteen deaths and 11 nonfatal major events occurred. The prevalence of underlying coronary arterial disease was higher in patients with major events than in others (33% vs. 7%), as was the degree of left ventricular (LV) systolic dysfunction (LV ejection fraction 46% ± 10 vs. 52% ± 8). Baseline E/Em, either pre-dialytic or post-dialytic, was significantly lower in event-free patients (pre-dialytic 9.9 ± 3.0 vs. 12.2 ± 4.0, p = 0.01; post-dialytic 9.2 ± 2.9 vs. 12.3 ± 3.6, p = 0.002). On Cox regression, factors significantly affecting outcomes were age, LV ejection fraction, LV mass index (hazard ratio [HR] = 1.021, 95% confidence interval [CI] 1.001-1.039, p = 0.021), and post-dialytic E/Em ≥12 (HR = 3.054, 95% CI 1.118-11.184, p = 0.009). Conclusion: Like LV dysfunction and LV mass index, a high post-dialytic E/Em was prognostic of major events.

Original languageEnglish
Pages (from-to)254-262
Number of pages9
JournalActa Cardiologica Sinica
Issue number4
Publication statusPublished - Dec 1 2007
Externally publishedYes


  • Cardiovascular mortality
  • Echocardiography
  • Tissue Doppler imaging
  • Uremia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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