Prognostic significance of dilated inferior vena cava in advanced decompensated heart failure

Hsin Fu Lee, Lung An Hsu, Chi Jen Chang, Yi Hsin Chan, Chun Li Wang*, Wan Jing Ho, Pao Hsien Chu

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

25 Scopus citations

Abstract

Dilated inferior vena cava (IVC) is prevalent among patients with heart failure (HF), but whether its presence predicts worsening renal function (WRF) or adverse outcomes is unclear. This cohort study analyzed patients with left ventricular ejection fraction <40 % and repeated hospitalizations (≥2 times) for HF between August 2009 and August 2011. The study endpoints were death and HF re-hospitalization. Among baseline parameters, IVC diameter was the most powerful predictor for the development of WRF (area under the curve = 0.795, cut-off value = 20.5 mm). During the 2-year follow-up, 36 patients (49 %) were re-hospitalized for HF and 14 patients (19 %) died. The event rates were significantly greater in the WRF group than in the non-WRF group (71 vs. 30 %, P < 0.001 for HF re-hospitalization; 29 vs. 10 %, P = 0.03 for death). In Cox regression model, the risk of combined end-points was increased in patients with aging, elevated blood urine nitrogen, IVC >21 mm, and WRF. When adjusted for confounding factors, IVC >21 mm [hazard ratio (HR) 3.73, 95 % confidence interval (CI) 1.66–8.34] and WRF (HR 2.68, 95 % CI 1.07–6.75) were significant predictors for adverse outcomes. In patients with advanced decompensated HF, dilated IVC (>21 mm) predicted the development of WRF and could be a predictor for adverse outcomes.

Original languageEnglish
Pages (from-to)1289-1295
Number of pages7
JournalInternational Journal of Cardiovascular Imaging
Volume30
Issue number7
DOIs
StatePublished - 10 2014

Bibliographical note

Publisher Copyright:
© 2014, Springer Science+Business Media Dordrecht.

Keywords

  • Heart failure
  • Inferior vena cava
  • Survival
  • Worsening renal function

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