Increased Central Venous Pressure Is Associated With Impaired Renal Function and Mortality in a Broad Spectrum of Patients With Cardiovascular Disease
Increased Central Venous Pressure Is Associated With Impaired Renal Function and Mortality in a Broad Spectrum of Patients With Cardiovascular Disease
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DOI：
10.1016/j.jacc.2008.08.080
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发表时间：
2009-02-17
影响因子：
24
通讯作者：
Hillege, Hans L.
中科院分区：
文献类型：
--
作者：
Damman, Kevin;van Deursen, Vincent M.;Hillege, Hans L.
Objectives我们试图研究中心静脉压（CVP）升高、肾功能和心血管病患者死亡率之间的关系。背景心血管疾病肾功能受损的病理生理学是多因素的。增加中心静脉压的相对重要性还没有得到解决previous.Methods一个共2,557例接受右心导管插入在格罗宁根大学医学中心，荷兰，1989年1月1日至2006年12月31日，被确定，他们的数据从电子数据库中提取。估计肾小球滤过率（eGFR）进行了评估与简化修改饮食肾脏疾病formulation.Results平均年龄为59 +/- 15岁，57%是男性。平均eGFR为65 ± 24 ml/min/1.73 m2，心脏指数为2.9 ± 0.8 l/min/m2，CVP为5.9 ± 4.3 mm Hg。CVP与心脏指数（r =-0.259，p < 0.0001）和eGFR（r =-0.147，p < 0.0001）相关。此外，心脏指数与eGFR相关（r = 0.123，p < 0.0001）。在多变量分析中，CVP仍然与eGFR相关（r =-0.108，p < 0.0001）。中位随访时间为10.7年，741例（29%）患者死亡。我们发现，CVP是一个独立的预测生存率降低（风险比：1.03每毫米汞柱增加，95%置信区间：1.01至1.05，p = 0.0032）。结论增加CVP与肾功能受损和独立相关的全因死亡率在广泛的心血管疾病患者。（J Am科尔心脏病学杂志2009; 53：582-8）（C）2009年美国心脏病学会基金会
Objectives We sought to investigate the relationship between increased central venous pressure (CVP), renal function, and mortality in a broad spectrum of cardiovascular patients.Background The pathophysiology of impaired renal function in cardiovascular disease is multifactorial. The relative importance of increased CVP has not been addressed previously.Methods A total of 2,557 patients who underwent right heart catheterization in the University Medical Center Groningen, the Netherlands, between January 1, 1989, and December 31, 2006, were identified, and their data were extracted from electronic databases. Estimated glomerular filtration rate (eGFR) was assessed with the simplified modification of diet in renal disease formula.Results Mean age was 59 +/- 15 years, and 57% were men. Mean eGFR was 65 +/- 24 ml/min/1.73 m(2), with a cardiac index of 2.9 +/- 0.8 l/min/m(2) and CVP of 5.9 +/- 4.3 mm Hg. We found that CVP was associated with cardiac index (r = -0.259, p < 0.0001) and eGFR (r = -0.147, p < 0.0001). Also, cardiac index was associated with eGFR (r = 0.123, p < 0.0001). In multivariate analysis CVP remained associated with eGFR (r = -0.108, p < 0.0001). In a median follow-up time of 10.7 years, 741 (29%) patients died. We found that CVP was an independent predictor of reduced survival (hazard ratio: 1.03 per mm Hg increase, 95% confidence interval: 1.01 to 1.05, p = 0.0032).Conclusions Increased CVP is associated with impaired renal function and independently related to all-cause mortality in a broad spectrum of patients with cardiovascular disease. (J Am Coll Cardiol 2009; 53: 582-8) (C) 2009 by the American College of Cardiology Foundation