Abstract: TH-PO111
Impact of Elevated Echocardiographic Index of Left Ventricular Filling Pressure on AKI After Aortic Valve Replacement
Session Information
- AKI: Biomarkers, Drugs, Onco-Nephrology
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Lee, Soo youn, Sejong General Hospital, Bucheon, Korea (the Republic of)
- Kang, Jae young, Sejong General Hospital, Bucheon, Korea (the Republic of)
Background
Increased LV filling pressure was found to be associated with deterioration of renal function in patients with congestive heart failure. However, it remains unclear how to contribute to cardio-renal interaction in patients who underwent aortic valve replacement (AVR).
We sought to evaluate the association between preoperative echocardiographic index of left ventricular (LV) filling pressure and postoperative acute kidney injury (AKI), and impact of AKI on clinical adverse outcomes after surgical AVR.
Methods
We conducted a retrospective study of 576 patients (292 males, mean age 68±10 years) who underwent surgical AVR. Patients were stratified according to E/e’ ratio above and less than 15, and assessed for AKI using the KDIGO criteria, defined as either a serum creatinine rise >0.3 mg/dl, or an increase in serum creatinine ≥1.5 times baseline within 7 days after AVR. The clinical adverse outcomes were early and long-term mortality, and hospitalization due to heart failure.
Results
Patients with E/e’ratio ≥15 had more AKI complication after surgical AVR (52.1% vs. 38.2%, p=0.001), In multivariable analysis, E/e’ratio ≥15 was independently associated with AKI after surgical AVR (odd ratio [OR], 1.66; 95% confidence interval [CI], 1.17–2.34 p=0.005). The Cox hazard model reveals that AKI (hazard ratio [HR], 1.57; 95% CI, 1.03-2.39, p=0.037) and advanced age (HR, 1.07; 95% CI, 1.04-1.11, p<0.001), coronary artery disease (HR 1.54, 95% CI, 1.02-2.32, p=0.04) were poor prognostic factors for clinical adverse outcomes after surgical AVR.
Conclusion
Among patients who undergoing surgical AVR, preoperative elevated LV filling pressure is associated with increased risk for AKI, and AKI is related to postopearative adverse clinical outcomes.