A combined echocardiographic indicator of elevated E/e' ratio and left ventricular hypertrophy independently predicted an increased risk of HFpEF rehospitalization (HR 2.65) in patients with stage 3-4 CKD.
Cohort (n=254)
No
Does a combined echocardiographic indicator (E/e' ≥15 and LVH) improve risk stratification for HFpEF rehospitalization in adults with HFpEF and stage 3-4 CKD?
A combined echocardiographic indicator of E/e' ≥15 and LVH improves risk stratification for rehospitalization in patients with HFpEF and stage 3-4 CKD.
Effect estimate: HR 2.65 (95% CI 1.59-4.41)
p-value: p=<0.001
Introduction Patients with heart failure with preserved ejection fraction (HFpEF) and coexisting chronic kidney disease (CKD) have poor outcomes. This study assessed whether a combined echocardiographic indicator could improve risk stratification for this high-risk group. Methods In a retrospective study of 254 adults with HFpEF and stage 3–4 CKD, we evaluated an indicator combining elevated E/e' ratio (≥15) and left ventricular hypertrophy (LVH). The primary outcome was rehospitalization for HFpEF. Statistical analyses included Cox regression, C-index, and decision curve analysis. Results Over a 2.1-year median follow-up, 26.8% of patients were rehospitalized. The combined indicator was a strong, independent predictor of this outcome. It demonstrated superior discrimination (C-index 0.74) compared to either E/e' (0.67) or LVH (0.65) alone, showing clinical utility across a range of risk thresholds. Conclusion A combined echocardiographic indicator integrating E/e' and LVMI improves risk stratification in patients with HFpEF and advanced CKD.
Xie et al. (Thu,) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) and stage 3-4 chronic kidney disease (CKD) (n=254). Combined echocardiographic indicator (E/e' ratio ≥ 15 and left ventricular hypertrophy) vs. Negative combined indicator was evaluated on First rehospitalization for HFpEF (HR 2.65, 95% CI 1.59-4.41, p=<0.001). A combined echocardiographic indicator of elevated E/e' ratio and left ventricular hypertrophy independently predicted an increased risk of HFpEF rehospitalization (HR 2.65) in patients with stage 3-4 CKD.