Cardiothoracic Ratio Association With Mortality in Patients on Maintenance Peritoneal Dialysis

Chen, Kuan‐Hsing; Hung, Cheng-Chieh; Lin-Tan, Dan-Tzu; Huang, Wen‐Hung; Ching-Wei, Hsu; Weng, Shu-Man; Lin, Jing

doi:10.1111/j.1744-9987.2010.00860.x

Cited by 19 publications

(25 citation statements)

References 29 publications

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“…To our knowledge, there is no article on the influence of anemia on the CTR in nondialyzed ESKD patients. A recent report has shown that the Hb level is inversely associated with the CTR independent of confoundable variables in chronic peritoneal dialysis patients [18]. Our study has confirmed the same finding at the initiation of the dialysis, which may result from the management of anemia in the predialytic phase of the CKD course.…”

Section: Discussionsupporting

confidence: 80%

“…The CTR negatively correlates with cardiac systolic dysfunction in patients with congestive heart failure [14]. A CTR >50% is associated with a poorer prognosis in community-dwelling elderly populations aged nearly 80 years [15] as well as in patients with congestive heart failure [16] and in those on dialysis [17,18]. Therefore, CTR would be an easier way to determine the status of cardiac remodeling.…”

Section: Introductionmentioning

confidence: 99%

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Association between the Hemoglobin Level and Cardiothoracic Ratio in Patients on Incident Dialysis

et al. 2014

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Background/Aim: The present study exploresassociations between hemoglobin (Hb) levels and patients with cardiac enlargement in end-stage kidney disease (ESKD) to help prevent cardiac remodeling during the predialysis phase of chronic kidney disease (CKD). Methods: This cross-sectional study included 2,249 patients with ESKD (age, 67 w 13 years; male, 67%; diabetic kidney disease, 41%) who started hemodialysis (HD) between January 2006 and October 2013 at eight participating hospitals. We examined associations between Hb levels immediately before the first HD session and cardiothoracic ratios (CTRs). Clinical factors associated with the CTR were also assessed. Results: The mean Hb level was 8.7 w 1.6 g/dl, and the mean and median CTRs were 55.0 and 54.7%, respectively. The correlation between the Hb level and the CTR was linear and negative (r = -0.129, p < 0.001). The mean CTR and the prevalence of patients with a CTR >50% obviously decreased with increasing Hb levels (both p < 0.001 for trend). Univariate logistic regression analysis revealed an approximately 20% reduction in the odds ratio for complicating CTRs >50% per 1 g/dl increase in Hb. Hb levels of <9 g/dl were significantly associated with CTRs >50%. Numerical and categorical Hb remained significantly associated with CTRs >50% after adjusting for confounding variables. Conclusions: Lower Hb levels participate in progressive CTR enlargement in patients with ESKD, and maintaining Hb levels of >9 g/dl might help prevent cardiac remodeling during the predialysis phase of CKD. i 2014 S. Karger AG, Basel

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Association between the Hemoglobin Level and Cardiothoracic Ratio in Patients on Incident Dialysis

et al. 2014

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“…Studies carried out on human beings have shown a significant association between CTR, malnutrition and anemia, which are conditions that can lead to alterations in normal heart sounds under auscultation. 6 Furthermore, the CTR was a predictor of 13% mortality in patients with heart disease of any nature. 12 …”

Section: Discussionmentioning

confidence: 99%

CARDIOTHORACIC RATIO AND VERTEBRAL HEART SCALE IN CLINICALLY NORMAL BLACK-RUMPED AGOUTIS (DASYPROCTA PRYMNOLOPHA, WAGLER 1831)

Moura¹,

Diniz²,

Moura³

et al. 2015

Journal of Zoo and Wildlife Medicine

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Wild rodents, such as the lowland paca (Cuniculus paca), capybara (Hydrochoerus hydrochaeris), rock cavy (Kerodon rupestris), guinea pig (Cavia aperea), and black-rumped agouti (Dasyprocta prymnolopha) are intensely hunted throughout Amazonia and at the semiarid regions of northeastern Brazil. To contribute to the preservation of these species, more information about their anatomy, physiology and pathophysiology is needed. The aim of this study was to standardize the vertebral heart scale (VHS) and cardiothoracic ratio (CTR) in clinically normal black-rumped agouti, as well as to compare the results of these two methods, which are commonly used to evaluate the cardiac silhouette in domestic animals. Twelve healthy black-rumped agoutis, divided into two groups (six males and six females), obtained from the Nucleus for Wild Animal Studies and Conservation at the Federal University of Piauí, were radiographed in right and left lateral and dorsoventral projections. The values of the VHS were 8.00±0.31v (the number of thoracic vertebral length spanned by each dimension, starting at T4) for males and 8.11±0.41v for females, and there was no statistical difference between the decubitus (right and left) or between males and females (P>0.05). The CTR mean values obtained were 0.51±0.03 for males, and 0.52±0.02 for females, and there was no statistical difference between the genders (P>0.05). However, there was positive correlation between VHS and CTR (r=0.77 right decubitus and r=0.82 left decubitus). The thoracic and heart diameter had mean values of 6.72±0.61 and 3.48±0.30 cm (males), and for the females, it was 6.61±0.51 and 3.5±0.30 cm, respectively, and there was statistical difference between the genders. The results demonstrated high correlation between the VHS and CTR producing similar results, indicating similar clinical precision for assessing the size of the cardiac silhouette in the black-rumped agoutis.

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“…The CTR was calculated as the ratio of the maximum transverse cardiac diameter in millimeters to the maximum thoracic diameter in millimeters. We defined a normal CTR value as less than 0.5 [29,30]. …”

Section: Methodsmentioning

confidence: 99%

“…However, it was shown that inflammation predicts future increase in BP, suggesting that increased inflammatory state may precede the increase in BP [29]. Assessment of these conditions and constant research on new serum blood markers and instrumental parameters in patients with ESRD appear mandatory to reduce the high cardiovascular morbidity and mortality [30,31]. …”

Section: Introductionmentioning

confidence: 99%

Cardiac, Inflammatory and Metabolic Parameters: Hemodialysis versus Peritoneal Dialysis

Lai

Molfino

Russo³

et al. 2014

Cardiorenal Med

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Introduction: Mortality in dialysis patients is higher than in the general population, and cardiovascular disease represents the leading cause of death. Hypertension and volume overload are important risk factors for the development of left ventricular hypertrophy (LVH) in hemodialysis (HD) and peritoneal dialysis (PD) patients. Other factors are mainly represented by hyperparathyroidism, vascular calcification, arterial stiffness and inflammation. The aim of this study was to compare blood pressure (BP) and metabolic parameters with cardiovascular changes [cardiothoracic ratio (CTR), aortic arch calcification (AAC) and LV mass index (LVMI)] between PD and HD patients. Materials and Methods: 45 patients (23 HD and 22 PD patients) were enrolled. BP measurements, echocardiography and chest X-ray were performed in each patient to determine the LVMI and to evaluate the CTR and AAC. Inflammatory indexes, intact parathyroid hormone (iPTH)andarterial blood gas analysis were also evaluated. Results: LVMI was higher in PD than HD patients (139 ± 19 vs. 104 ± 22; p = 0.04). In PD patients, a significant correlation between iPTH, C-reactive protein and the presence of LVH was observed (r = 0.70, p = 0.04; r = 0.70, p = 0.03, respectively). The CTR was increased in PD patients as compared to HD patients, while no significant differences in cardiac calcifications were determined. Conclusions: Our data indicate that HD patients present more effective BP control than PD patients. Adequate fluid and metabolic control are necessary to assess the adequacy of BP, which is strongly correlated with the increase in LVMI and with the increased CTR in dialysis patients. PD is a home therapy and allows a better quality of life, but PD patients may present a further increased cardiovascular risk if not adequately monitored. © 2014 S. Karger AG, Basel

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Cardiothoracic Ratio Association With Mortality in Patients on Maintenance Peritoneal Dialysis

Cited by 19 publications

References 29 publications

Association between the Hemoglobin Level and Cardiothoracic Ratio in Patients on Incident Dialysis

Association between the Hemoglobin Level and Cardiothoracic Ratio in Patients on Incident Dialysis

CARDIOTHORACIC RATIO AND VERTEBRAL HEART SCALE IN CLINICALLY NORMAL BLACK-RUMPED AGOUTIS (DASYPROCTA PRYMNOLOPHA, WAGLER 1831)

Cardiac, Inflammatory and Metabolic Parameters: Hemodialysis versus Peritoneal Dialysis

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