Effect of right ventricular dysfunction on mortality in patients undergoing maintenance hemodialysis: a retrospective cohort study

Author:

Nobayashi Hiroki1,Bamba Harui1,Iida Tomomichi2,Aoyagi Ryuji2,Maruyama Yukio1,Yokoo Takashi1

Affiliation:

1. Jikei University School of Medicine

2. Tachikawa General Hospital

Abstract

Abstract

Background: Cardiovascular disease is a major complication in patients on maintenance hemodialysis (MHD), and heart failure is the leading cause of death among them. While the effectt 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 April 2022 and 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. The Kaplan–Meier survival analysis was used to compare survival between patients with and without RV dysfunction. The univariate and multivariate Cox regression analyses were used to estimate the effects of RV dysfunction on all-cause mortality. Results: Twenty out of 149 patients on MHD (13%) had RV dysfunction. Indexes of their left ventricular (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 (9 patients with RV dysfunction and 14 patients without RV 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 was independently associated with all-cause mortality (Hazard ratios: 3.55; 95%confidence intervals, 1.39–9.05). Conclusions: RV dysfunction is a significant risk factor for all-cause mortality among patients on MHD.

Publisher

Springer Science and Business Media LLC

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