Evaluating and predicting of the cardiac function class and re-hospitalization in CHD with HF using IVC diameter and collapsibility index.

چکیده اصلی

AIMS: Transthoracic echocardiography is widely used to assess the volume status of patients with coronary heart disease combined with heart failure (CHD-HF) because of its noninvasive and convenient nature. Inferior vena cava (IVC) measurement is a commonly used alternative method for evaluating central venous pressure. This study analyzed the specific clinical applications of IVC diameter (IVCD) and collapse index (IVCCI) in assessing the cardiac dysfunction severity and prognosis of CHD-HF patients. METHODS: A retrospective analysis was conducted on 340 CHD patients treated at our hospital between January 2021 and March 2023. Patients were categorized into CHD (n = 123) and CHD-HF (n = 217) groups. Ultrasound measurements of IVCD and IVCCI were performed, and 2-year follow-up data were compiled to record cardiovascular re-hospitalization and all-cause death. Spearman or Pearson was utilized for correlation analysis. ROC analysis was used for performance analysis, and Kaplan-Meier and Cox regression were harnessed for survival analysis. RESULTS: CHD-HF patients showed increased IVCD and decreased IVCCI. CHD-HF patients experiencing cardiovascular re-hospitalization or all-cause death exhibited elevated IVCD and reduced IVCCI. IVCD (AUC = 0.715, 95%CI = 0.638-0.792, cut-off = 14.15 mm; AUC = 0.795, 95%CI = 0.732-0.858, cut-off = 13.04 mm) and IVCCI (AUC = 0.790, 95%CI = 0.726-0.853, cut-off = 51.47%; AUC = 0.731, 95%CI = 0.661-0.801, cut-off = 50.00%) demonstrated high predictive values for cardiovascular re-hospitalization and all-cause death in CHD-HF patients. IVCD (HR = 1.124, 95%CI = 1.056-1.196; HR = 1.139, 95%CI = 1.078-1.203) and IVCCI (HR = 0.959, 95%CI = 0.921-0.999; HR = 0.956, 95%CI = 0.921-0.992) were both independently associated with cardiovascular re-hospitalization and all-cause death in CHD-HF patients. CONCLUSION: IVCD and IVCCI effectively predict cardiovascular re-hospitalization and all-cause death in CHD-HF patients.

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