PMID- 27550512 OWN - NLM STAT- MEDLINE DCOM- 20170221 LR - 20220408 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 106 IP - 2 DP - 2017 Feb TI - Echocardiographic correlates of left ventricular filling pressures and acute cardio-renal syndrome in ST segment elevation myocardial infarction patients. PG - 120-126 LID - 10.1007/s00392-016-1031-8 [doi] AB - OBJECTIVE: Increased transmitral flow velocity (E) to the early mitral annulus velocity (e') ratio (E/e'), signifying increased cardiac filling pressure, was previously found to be associated with deterioration of renal function in patients with congestive heart failure. No study, however, included patients with acute myocardial ischemia. We hypothesized that elevated E/e' ratio would be associated with an increased risk of acute kidney injury (AKI) in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). STUDY DESIGN AND METHODS: We conducted a retrospective study of 804 consecutive STEMI patients between June 2012 and December 2015 who underwent primary PCI and had a comprehensive echocardiographic examination performed within 72 h of hospital admission. Patients were stratified according to E/e' ratio above and 0.3 mg/dl, or an increase in serum creatinine >/=1.5 times baseline. RESULTS: Patients with E/e' ratio >15 had lower left ventricular (LV) ejection fraction, higher systolic pulmonary artery pressures, as well as right atrial pressures, and demonstrated worse in-hospital outcomes. Patients with E/e' ratio >15 had more AKI complicating STEMI (27 vs. 7 %; p < 0.001). In multivariate logistic regression model, E/e' ratio >15 was independently associated with AKI (OR = 1.87, 95 % CI 0.99-3.52; p = 0.05). Other variables associated with AKI included diabetes, LV ejection fraction, and glomerular filtration rate. CONCLUSIONS: Among STEMI patients undergoing primary PCI, the early E/e' ratio >15 was associated with increased risk for AKI. FAU - Flint, Nir AU - Flint N AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Kaufman, Natalia AU - Kaufman N AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Gal-Oz, Amir AU - Gal-Oz A AD - Department of Nephrology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Margolis, Gilad AU - Margolis G AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Topilsky, Yan AU - Topilsky Y AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Keren, Gad AU - Keren G AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Shacham, Yacov AU - Shacham Y AUID- ORCID: 0000-0003-0805-3185 AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. kobyshacham@gmail.com. LA - eng PT - Journal Article PT - Observational Study DEP - 20160822 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Acute Kidney Injury/diagnosis/*etiology/physiopathology MH - Aged MH - Aged, 80 and over MH - Cardio-Renal Syndrome/diagnosis/*etiology/physiopathology MH - Chi-Square Distribution MH - *Echocardiography, Doppler MH - Female MH - Humans MH - Israel MH - Logistic Models MH - Male MH - Middle Aged MH - Mitral Valve/diagnostic imaging/physiopathology MH - Multivariate Analysis MH - Odds Ratio MH - Percutaneous Coronary Intervention/*adverse effects MH - Predictive Value of Tests MH - Retrospective Studies MH - Risk Factors MH - ST Elevation Myocardial Infarction/*diagnostic imaging/physiopathology/*therapy MH - Treatment Outcome MH - *Ventricular Function, Left MH - *Ventricular Pressure OTO - NOTNLM OT - Acute kidney injury OT - Left ventricular filling pressures OT - Percutaneous coronary intervention OT - ST elevation myocardial infarction EDAT- 2016/08/24 06:00 MHDA- 2017/02/22 06:00 CRDT- 2016/08/24 06:00 PHST- 2016/06/29 00:00 [received] PHST- 2016/08/17 00:00 [accepted] PHST- 2016/08/24 06:00 [pubmed] PHST- 2017/02/22 06:00 [medline] PHST- 2016/08/24 06:00 [entrez] AID - 10.1007/s00392-016-1031-8 [pii] AID - 10.1007/s00392-016-1031-8 [doi] PST - ppublish SO - Clin Res Cardiol. 2017 Feb;106(2):120-126. doi: 10.1007/s00392-016-1031-8. Epub 2016 Aug 22.