Kidney function and the prognostic value of myocardial performance index
- 21 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in The International Journal of Cardiovascular Imaging
- Vol. 37 (5), 1637-1647
- https://doi.org/10.1007/s10554-020-02149-0
Abstract
A decreased glomerular filtration rate (GFR) is a risk factor for cardiovascular disease even after adjustment for conventional risk factors. The myocardial performance index (MPI) is defined as (isovolumetric relaxation time (IVRT) + isovolumetric contraction time (IVCT))/ejection time (ET). It has been shown to be an independent predictor of cardiovascular events. We hypothesized the MPI could prove valuable for assessing cardiac risk in subjects of the general population with decreased estimated GFR (eGFR). MPI was measured in 1915 subjects from a large general population prospective cohort study using color tissue Doppler imaging (TDI) M-mode through the mitral valve. We compared the prognostic capabilities of the MPI between subjects with eGFR ≥ 75 mL/min/1.73 m2 and subjects with eGFR < 75 mL/min/1.73 m2 using multivariable adjusted Cox regression models. The composite endpoint was heart failure, myocardial infarction or cardiovascular death. Mean age was 58 years (SD 16.2), 58% were women, 42% had hypertension and 8.3% diabetes. During a median follow-up time of 12.4 years [IQR 10.6–12.7 years] 269 participants reached the combined endpoint. eGFR modified the prognostic capability of MPI (p-value for interaction < 0.001): After multivariable adjustment, MPI remained an independent predictor of the composite endpoint only in participants with eGFR < 75 mL/min/1.73 m2: HR 1.18 (95% CI 1.02–1.38), p = 0.03, vs. in subjects with eGFR ≥ 75 mL/min/1.73 m2: HR 1.14 (95% CI 0.94–1.39), p = 0.17. These results suggest the MPI could be particularly valuable for identifying elevated cardiac risk in individuals from the general population with decreased eGFR.Funding Information
- Region Hovedstaden
This publication has 61 references indexed in Scilit:
- Prognostic Value of Cardiac Time Intervals by Tissue Doppler Imaging M-Mode in Patients With Acute ST-Segment–Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary InterventionCirculation: Cardiovascular Imaging, 2013
- Relation between right and left ventricular function in patients undergoing chronic dialysisJournal of Cardiovascular Medicine, 2013
- FGF23 induces left ventricular hypertrophyJCI Insight, 2011
- Usefulness of the Myocardial Performance Index Determined by Tissue Doppler Imaging M-Mode for Predicting Mortality in the General PopulationThe American Journal of Cardiology, 2011
- Serum fibroblast growth factor-23 (FGF-23) levels are independently associated with left ventricular mass and myocardial performance index in maintenance haemodialysis patientsNephrology Dialysis Transplantation, 2010
- Fibroblast Growth Factor 23 and Mortality among Patients Undergoing HemodialysisThe New England Journal of Medicine, 2008
- A Doppler-derived index of combined left ventricular systolic and diastolic function is an independent predictor of cardiovascular mortality in elderly menAmerican Heart Journal, 2005
- Kidney Disease as a Risk Factor for Development of Cardiovascular DiseaseHypertension, 2003
- Prognostic importance of systolic and diastolic function after acute myocardial infarctionAmerican Heart Journal, 2003
- Congestive heart failure despite normal left ventricular systolic function in a population-based sample: the Strong Heart StudyThe American Journal of Cardiology, 2000