Skip to main content
Download PDF

Effect of cardiac function in patients with gastrointestinal cancer with or without acute kidney injury assessed using a non-invasive impedance cardiography: a case-control study

BMC Cardiovascular Disorders volume 23, Article number: 490 (2023) Cite this article

Abstract

Objectives

This study aimed to analyze the possible causes of changes in cardiac function and investigate the feasibility of clinical assessment of gastrointestinal cancer in patients with or without acute kidney injury (AKI) assessed using a non-invasive impedance cardiography (ICG, Bioz. Cardio Dynamics, USA) to identify independent risk factors.

Methods

Patients admitted to the Fourth Hospital of Hebei Medical University, China, between May 1, 2019, and February 15, 2022, were included in this study. A total of 51 patients with gastrointestinal cancer (31 men and 20 women, mean age 61.1 ± 10.9 years) with or without AKI were evaluated for ICG. A total of 19 patients underwent ultrasound cardiography (UCG) and ICG evaluations.

Result

There was a significant positive correlation between cardiac output (CO), cardiac index (CI), stroke volume (SV), left cardiac work index (LCWI), and ejection fraction (EF) measured using UCG and ICG. The relationship was observed between COICG and COUCG (r = 0.707, P = 0.001), CIICG and CIUCG (r = 0.718, P = 0.001), SVICG and SVUCG (r = 0.837, P < 0.001), and LCWIICG and EFUCG (r = 0.540, P = 0.017). Cardiac function parameters measured using ICG were statistically different between patients with gastrointestinal cancer with or without AKI (P ≤ 0.05). Multivariate analysis revealed that AKI independently affects cardiac function in patients with gastrointestinal cancer.

Conclusions

UCG and ICG methods are significantly associated with cardiac function in patients with or without AKI, and patients with gastrointestinal cancer with AKI are worse than those without AKI. AKI is an independent risk factor for cardiac function in patients with gastrointestinal cancer.

Peer Review reports

Introduction

Acute kidney injury (AKI) affects up to half of cancer patients. AKI in cancer patients is a major consequence linked to significantly longer hospital stays and higher expenses for various illnesses [1,2,3,4]. The development of AKI in cancer patients continues to be associated with high mortality rates, although survival rates have increased over the last decade [4,5,6,7,8]. A side effect of cancer treatment or the disease itself is the reason for the rising mortality rate [9,10,11]. AKI is also essential to this process.

As we all know, renal aggravation and heart failure frequently coexist in patients and worsen one another. The term “cardiorenal syndrome” (CRS) was originally used in 2007 by renowned Italian professor Ronco. According to him, type 3 CRS manifests as a sudden decline in renal function that results in acute cardiac dysfunction [12]. Additionally, most research indicates that AKI frequently coexists with multiple organ dysfunction in critically ill cancer patients [7, 8, 12]. However, few studies have examined the cardiac function of patients with gastrointestinal cancer and AKI.

It is difficult to determine the volume status of patients by evaluating their symptoms and performing a physical examination alone. For this reason, impedance cardiography (ICG) was developed as a non-invasive technique that could produce a variety of cardiocirculatory parameters [13,14,15,16,17,18]. Careful data analysis can identify occult hypovolemia and titrate the optimal dose. Recently, ICG has been suggested as a noninvasive, continuous, operator-independent, and cost-effective approach used in ICUs [19,20,21,22,23,24]. However, very few studies specifically address the use of ICG in nephrology, especially in patients with gastrointestinal cancer and AKI. The present study aimed to evaluate the two methods—ICG and ultrasound cardiography (UCG)—for assessing cardiac function in patients with gastrointestinal cancer and to identify the factors that may differ between patients with or without AKI.

Materials and methods

Design and subjects

This case-control study began on May 1, 2021, and ended on February 15, 2023. During this time, patients with malignant tumors of the gastrointestinal system or AKI were selected from the departments of nephrology, gastroenterology, and hepatobiliary surgery of the Fourth Hospital of Hebei Medical University. This study made use of a single-center database. All patients receiving ultrasound and impedance cardiography had their demographic, laboratory, and clinical data collected by trained physicians.

Selection of participants and description of data

Patients in our study were divided into case and control groups. The case group: included 25 patients (16 males and nine females) with gastrointestinal cancer and AKI. Inclusion criteria: (a) the primary diseases were cancer of the gastrointestinal system; (b) either the serum creatinine level or the urine output criterion was used to diagnose AKI and, based on the acute kidney injury network (AKIN) stage, determined for each patient; (c) the body mass index (BMI) ranged from 18.5 to 23.9 kg/m2, (d) there was no hydrothorax, peritoneal effusion, metal support, or pacemaker in vivo; and (e) volunteering in this study. Exclusion criteria: (a) basal cardiac diseases, including coronary artery disease, pulmonary heart disease, myocardial infarction, and heart failure; (b) BMI < 18.5 kg/m2 or > 23.9 kg/m2; (c) a history of thoracic operation; (d) severe hypertension mean arterial pressure > 130 mmHg; (e) sepsis shock; (f) chronic kidney disease; and (g) patients who could not cooperate. The control group: included 26 patients (15 males and 11 females) with gastrointestinal cancer without AKI. The case group (c-e) served as the inclusion criteria, and the case group (a-g) served as the exclusion criteria. AKI was categorized at the time of hospitalization using AKIN criteria. A malignancy must be a pathologically proven diagnosis in cancer patients. For this study, only cancer patients with gastrointestinal cancer were considered.

After receiving consent, 19 patients with gastrointestinal cancer underwent UCG (GE Vivid7; Netherlands) and ICG monitoring (Cardio Dynamics, San Diego, California, USA) measurements. The parameters were saved in the electronic memory of the monitor for subsequent analysis. Patients were cared for throughout the study based on the judgment of their regular physicians, who were unaware of the results of the ICG test.

Measures

After admission, general clinical data such as age, sex, BMI, history of hypertension or diabetes mellites, TNM stage, stage of AKI, etiology of AKI, hemoglobin, leukocyte, platelet, blood albumin, serum creatinine and urea nitrogen were collected. A total of 19 patients (8 cases in the case group and 11 cases in the control group) with gastrointestinal malignant tumors were examined by echocardiography using GE vivid 7-color Doppler ultrasound, and noninvasive hemodynamic monitoring was then performed. Only the cardiac function indicators were recorded for the remaining patients, who were only continually monitored for 5–10 min using the BioZ.com non-invasive hemodynamic monitor produced by Cardio Dynamics in the United States. Cardiovascular parameters such as cardiac output (CO), cardiac index (CI), stroke index (SI), stroke volume (SV), acceleration index (ACI), velocity index (VI), left cardiac work index (LCWI), left cardiac work (LCW), thoracic fluid content (TFC), systemic vascular resistance (SVR), and systemic vascular resistance index (SVRI) were also included.

Statistical analysis

The Statistical Package for Social Sciences package (version 25.0; SPSS, Chicago, IL) was used to perform the statistical analyses. Noninvasive hemodynamic monitoring and echocardiography were performed to assess cardiac function, and linear correlation analysis was used to assess the corresponding indexes. The corresponding clinical and cardiac function indicators of the collected case group and the control group were subjected to a univariate analysis. Since the measurement data followed a normal distribution (mean ± standard deviation), the median (interquartile distance) can represent a non-normal distribution. For ordered and categorical variables, a nonparametric test was used. To find risk factors affecting cardiac function in patients with gastrointestinal malignancies complicated with AKI, multivariate linear regression analysis was performed on variables with statistical significance (P ≤ 0.05).

Results

Characterization of the study population

Over the course of the study, 51 patients were included, with a mean age of 61.00 ± 10.96 years and a confirmed diagnosis of malignancy in each of them. From these patients, (n = 17, 33%) had gastric cancer, (n = 15, 29%) had liver cancer, (n = 7, 14%) had cholangiocarcinoma, (n = 5, 10%) had rectal cancer, (n = 4, 8%) had colon cancer, (n = 3, 6%) had pancreatic cancer. Table 1 shows the basic characteristics of the study population. Table 2 shows cardiac function parameters measured by ICG.

Table 1 The basic characteristics of patients with gastrointestinal cancer with or without AKI a
Full size table
Table 2 Cardiac function parameters measured by ICGa
Full size table

Table 3 showed that patients with gastrointestinal cancer and AKI had higher cardiac afterload parameters TFC and SVRI levels than those without AKI, which was statistically significant (P < 0.01). In patients with gastrointestinal cancer and AKI, CO, CI, SI, SV, VI, ACI, and LCWI were lower than those without AKI.

Table 3 Multiple regression analysis of variables affected the cardiac function
Full size table

Comparison between ICG and UCG methods

We examined 19 patients with gastrointestinal cancer (11 men and 8 women), whose average age was 61.8 ± 12.2 years and whose BMI was 21.15 ± 1.20 kg/m2. SVICG ranged from 37 to 86 ml, and SVUCG ranged from 34 to 87 ml. We discovered a significant positive correlation between SVICG and SVUCG (r = 0.837; P < 0.001). COICG ranged from 3.2 to 6.5 L.min− 1, and COUCG ranged from 3.3 to 5.9 L.min− 1. There was significant positive significance between COICG and COUCG (r = 0.707; P = 0.001). CIICG ranged from 2.3 to 3.5 L.min− 1.m− 2. Additionally, we observed a significant positive correlation between CIICG and CIUCG (r = 0.718; P = 0.001). EF%UCG ranged from 0.41 to 0.77, and LCWIICG ranged from 1.4 to 5.1 kg. m. There was a significant positive correlation between CIICG and EF%UCG (r = 0.519; P = 0.009, LCWIICG, and EF%UCG (r = 0.540; P = 0.017) (Fig. 1).

Fig. 1
figure 1

Correlation with SV, CO, CI and LCWI measured by ICG and UCG methods

Abbreviations: SV Stroke volume, CO Cardiac output, CI Cardiac index, LCWI Left cardiac work index, ICG Impedance cardiography, UCG Ultrasound cardiography

Full size image

Noninvasive hemodynamic monitoring was used to compare the cardiac function indexes between the case group and the control group: (1) CO (4.20 ± 1.29 vs. 5.06 ± 1.11, P < 0.01); CI (2.45 ± 0.61 vs. 2.97 ± 0.54, P < 0.01) (Fig. 2); SI (27.08 ± 7.95 vs. 37.08 ± 7.50, P < 0.01); SV (45.8(5.82) vs. 62.78(10.1), P< 0.01; ACI (64.32(4.02) vs. 70.53(7.28), P < 0.05) VI (29.16(4.22) vs. 43.58(10.14), P < 0.01; LCWI (3.02 ± 0.92 vs. 3.49 ± 0.90, P < 0.05); and LCW (5.20 ± 0.76 vs.5.96 ± 0.70, P < 0.05) (Fig. 3). According to the findings mentioned above, there was a significant difference between the myocardial contractility, with the case group being significantly lower than the control group. (2) TFC (53.45 ± 8.49 vs. 33.24 ± 4.46, P < 0.01) (Fig. 3), the result demonstrated that the cardiac preload of the case group was significantly higher than that of the control group, and the difference between the two groups was significant. (3) The results revealed that the cardiac afterload of the case group was significantly higher than that of the control group and that the difference between the two groups was statistically significant SVR (1761.32 ± 301.66 vs.1374.5 ± 222.32, P < 0.05); SVRI (3043.8 ± 598.83 vs. 2314.35 ± 277.29, P < 0.01) (Fig. 4). The results revealed that the cardiac afterload of the case group was significantly higher than that of the control group and that the difference between the two groups was statistically significant.

Fig. 2
figure 2

The Cardiac function parameters: CO, CI Measured by Noninvasive hemodynamic monitoring

Note: *p<0.05 vs. the control group, statistically significant

Abbreviations: CO Cardiac output, CI Cardiac index

Full size image
Fig. 3
figure 3

The Cardiac function parameters: SI, ACI, VI, TFC Measured by Noninvasive hemodynamic monitoring

Note: *p<0.05 vs. the control group, statistically significant

Abbreviations: SI Stroke Index, ACI Acceleration Index, VI Velocity index, TFC Thoracic fluid content

Full size image
Fig. 4
figure 4

The Cardiac function parameters: SVR, SVRI Measured by Noninvasive hemodynamic monitoring

Note: *p<0.05 vs. the control group, statistically significant

Abbreviations: SVR Systemic vascular resistance, SVRI Systemic vascular resistance index

Full size image

Multivariate regression analysis identified AKI as an independent risk factor for cardiac dysfunction in patients with gastrointestinal cancer after significant factors selected by univariate regression analysis were entered, using SI and TFC as the primary cardiac function index. (r = 0.724, r = 0.585, r = 0.607, P < 0.05) (Table 3).

Discussion

AKI is a severe cancer consequence, significantly increasing morbidity and mortality [1,2,3,4,5, 27,28,29,30,31]. More than half of cancer patients had AKI, which had a dismal prognosis and a mortality rate as high as 78%, according to Maccariello [32] et al. According to a multicenter study [33], patients with severe AKI in the ICU had an in-hospital mortality rate of 60.3%, which suggests that patients with cancer who also have AKI have a higher mortality rate. Malignant tumors alone are not the only factor contributing to the increased mortality rate associated with complicated (or combined) cases of AKI and malignant tumors; AKI also has a significant impact. As can be seen, AKI rarely manifests as an independent disease; rather, it frequently occurs in conjugation with or as a result of the dysfunction of other organs. Hemodynamic instability, significant catabolic and volume overload, a poor prognosis, and a high mortality rate characterize it. Simultaneously, research [34, 35] has revealed that early and timely hemodynamic monitoring of critically ill patients is important to enhance cardiac output and increase kidney blood and urine volume. Given the above, it is crucial for clinical guidance to study the cardiac function status of patients with gastrointestinal malignant tumors complicated by AKI, screen for risk factors affecting the changes in cardiac function, investigate potential mechanisms and clinical significance, and intervene in the early stages of the clinical process to improve patient prognosis and lower mortality and treatment costs. Studies on the cardiac function of patients who have AKI complicated (or combined) by a malignant tumor have not yet been reported.

The current investigation verified that, while evaluating cardiac performance in patients with gastrointestinal cancer, both without AKI, the ICG and the UCG methods showed a statistically significant positive correlation. In 2004, Parrott et al. [25] found a strong correlation (r = 0.85) between changes in EF in patients with heart failure and changes in ICG heart index and systolic time ratio. ICG and CMR have comparable accuracy and concordance rates, as demonstrated by Erifyli et al. [26]; however, ICG cannot be substituted for CMR in patients with breast cancer. Additionally, there was a significant correlation between SVICG, COICG, SVUCG, and COUCG. Therefore, we conclude that ICG may be a practical, reliable, and economical method for monitoring cardiac function in patients with gastrointestinal cancer. According to most studies, AKI typically develops in the context of multiple organ dysfunction in critically ill cancer patients. This study found that the cardiac function parameters of CO, CI, SV, and ACI measured by ICG in gastrointestinal cancer patients with AKI were lower than those without AKI. In contrast, the TFC, SVR, and SVRI were significantly higher. This was done by comparing the cardiac function parameters in the case and control groups. In other words, heart insufficiency can be brought on by acute renal aggravation in patients with gastrointestinal cancer. At the same time, this study compared the hemoglobin, leukocyte, platelets, diabetes and hypertension history, heart rate and TNM stage of patients in the case group and the control group, and found no difference between the two groups. In addition, our study found differences in blood albumin between the two groups, which may be related to the late TNM stage of the patients, the higher proportion of AKIN stage 3, and the overall severity of the patients’ disease.

What is the mechanism of cardiac dysfunction in cancer patients with AKI? Over the last decade, growing data has revealed that fluid overload is linked to worse outcomes. Additionally, fluid overload is practically given in critically ill patients, particularly in the presence of AKI, and it has been demonstrated that the severity of fluid overload is correlated with a worse clinical outcome [7, 8, 36]. However, only a few studies have shown that cancer patients can experience AKI. In the present study, cardiac function parameters were examined between patients with gastrointestinal cancer with or without AKI, and it was found that TFC was higher in cancer patients with AKI than those without AKI. According to Yerram et al. [8], maintaining the proper fluid balance is essential for managing AKI. We performed multivariate analysis to find the independent determinants of cardiac dysfunction in patients with gastrointestinal cancer. Early ICG monitoring of cardiac function variables may be useful in reducing therapeutic inertia and patient non-adherence to treatment.

Limitations

This study has some limitations. First, there is insufficient data in this single-center case-control study because there was a small sample size (n = 51). Patients with gastrointestinal malignant tumors complicated (or combined) with AKI have a cardiac function influenced by several clinical factors, requiring a large-sample, multicenter study. Secondly, to minimize the impact of different stages of AKIN on the cardiac function of malignant tumors, the case group selected in this study mainly consisted of patients with gastrointestinal malignancies complicated with AKIN stage 3, and the cause of AKI was mainly postrenal and combined factors. Therefore, the number of patients with AKIN stage 1 and stage 2 and patients with prerenal and intrarenal factors of AKI needs to be increased to more thoroughly prove the influence of different AKIN stages and etiology of AKI on the cardiac function of malignant tumors. Third, the mortality and renal prognostic indexes of hospitalized patients with gastrointestinal malignancies complicated by AKI were not assessed due to the small sample size of this study.

Conclusion

Non-invasive hemodynamic monitoring and echocardiography correlate well in assessing cardiac function in gastrointestinal malignancies. AKI is closely related to cardiac function in patients with malignant tumors of the gastrointestinal system. AKI is an important risk factor affecting cardiac function changes in patients with malignant tumors of the gastrointestinal system. TFC is significantly increased when AKI occurs in patients with gastrointestinal system malignancies, and it has been hypothesized that internal volume overload may cause decreased cardiac function. Early monitoring of TFC can reduce the risk of cardiac dysfunction and provide new diagnostic and treatment strategies.

Data Availability

All data analyzed during the current study are included in this article. Further inquiries can be directed to the corresponding author.

Abbreviations

ACI:

Acceleration Index

CI:

Cardiac index

CO:

Cardiac output

LCW:

Left cardiac work

LCWI:

Left cardiac work index

SI:

Stroke Index

SV:

Stroke volume

SVR:

Systemic vascular resistance

SVRI:

Systemic vascular resistance index

TFC:

Thoracic fluid content

VI:

Velocity index

References

  1. Kim DW, Jang GS, Jung KS, et al. Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy. Kidney Res Clin Practice. 2022;41(6):717–29. https://doi.org/10.23876/j.krcp.21.305. Epub 2022 Jul 19.

    Article  Google Scholar 

  2. Mitchell H, Rosner MA, Perazella. Acute kidney injury in the patient with cancer. Kidney Res Clin Practice 2019; 38(3):295–308. https://doi.org/10.23876/j.krcp.19.042

  3. Christiansen CF, Johansen MB, Langeberg WJ, Fryzek JP, Sørensen HT. Incidence of acute kidney injury in cancer patients: a danish population-based cohort study. Eur J Intern Med. 2011;22:399–406. https://doi.org/10.1016/j.ejim.2011.05.005

    Article  PubMed  Google Scholar 

  4. Jin J, Wang Y, Shen Q, Gong J, Zhao L, He Q. Acute kidney injury in cancer patients: a nationwide survey in China. Sci Rep. 2019;9:3540. https://doi.org/10.1038/s41598-019-39735-9

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  5. Darmon M, Vincent F, Canet E, et al. Acute kidney injury in critically ill patients with haematological malignancies: results of a multicentre cohort study from the Groupe de Recherche en Réanimation respiratoire en Onco-Hématologie. Nephrol Dial Transplant. 2015;30:2006–13. https://doi.org/10.1093/ndt/gfv372

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lahoti A, Kantarjian H, Salahudeen AK, et al. Predictors and outcome of acute kidney injury in patients with acute myelogenous leukemia or high-risk myelodysplastic syndrome. Cancer. 2010;116:4063–8. https://doi.org/10.1002/cncr.25306

    Article  PubMed  Google Scholar 

  7. Darmon M, Ciroldi M, Thiery G, et al. Clinical review: specific aspects of acute renal failure in cancer patients. Crit Care. 2006;10:211–7. https://doi.org/10.1186/cc4907

    Article  PubMed  PubMed Central  Google Scholar 

  8. Preethi YE, Poorna R, KA, Madhukar MI. Fluid overload and acute kidney injury. Hemodial Int. 2010;14:348–54. https://doi.org/10.1111/j.1542-4758.2010.00498.x

    Article  Google Scholar 

  9. Lameire N, Vanholder R, Van Biesen W, Benoit D. Acute kidney injury in critically ill cancer patients: an update. Crit Care. 2016;20:209. https://doi.org/10.1186/s13054-016-1382-6

    Article  PubMed  PubMed Central  Google Scholar 

  10. Rosner MH, Perazella MA. Acute kidney injury in patients with cancer. N Engl J Med. 2017;376:1770–81. https://doi.org/10.1056/NEJMra1613984

    Article  PubMed  CAS  Google Scholar 

  11. Ben Sprangers DE, Leaf C, Porta, et al. Diagnosis and management of immune checkpoint inhibitor-associated acute kidney injury. Nat Rev Nephrol. 2022;18(12):794–805. https://doi.org/10.1038/s41581-022-00630-8

    Article  PubMed  CAS  Google Scholar 

  12. Ronco C, Haapio M, House AA, et al. Cardiorenal Syndrome Journal of the American College of Cardiology. 2008;52:1527–39. https://doi.org/10.1016/j.jacc.2008.07.051

    Article  PubMed  Google Scholar 

  13. Ismail PH-TU, Iain DC, Kirkpatrick, et al. Correlation of Impedance Cardiography-Derived and Cardiac magnetic resonance-derived stroke volumes. Curr Probl Cardiol. 2022;48(2):101457. https://doi.org/10.1016/j.cpcardiol.2022.101457

    Article  PubMed  Google Scholar 

  14. Gautam Anand Y, Yu A, Lowe, et al. Bioimpedance analysis as a tool for hemodynamic monitoring: overview, methods and challenges. Physiol Meas. 2021;42(3). https://doi.org/10.1088/1361-6579/abe80e

  15. Heyer Y, Baumgartner D, Baumgartner C. A systematic review of the Transthoracic Impedance during Cardiac Defibrillation. Sens (Basel). 2022;22(7):2808. https://doi.org/10.3390/s22072808

    Article  CAS  Google Scholar 

  16. Dávid Zakariás, Gábor, Marics K, Kovács et al. Clinical application of the electric cardiometry based non-invasive ICON® hemodynamic monitor. Orvosi Hetilap. 2018;159(44):1775–1781. https://doi.org/10.1556/650.2018.31225

  17. Waisman G. Current status of noninvasive hemodynamics in hypertension. Hipertens Riesgo Vasc. 2018 Jan-Mar;35(1):30–6. https://doi.org/10.1016/j.hipert.2017.11.004

  18. Siedlecka J, Siedlecki P, Alicja Bortkiewicz. Impedance cardiography – old method, new opportunities. Part I. Clinical applications. Int J Occup Med Environ Health. 2015;28(1):27–33. https://doi.org/10.13075/ijomeh.1896.00451

    Article  PubMed  Google Scholar 

  19. Melike Bayram, Clyde W. Yancy.Transthoracic impedance cardiography: a noninvasive method of hemodynamic assessment. Heart Fail Clin. 2009;5(2):161–8. https://doi.org/10.1016/j.hfc.2008.12.001

    Article  Google Scholar 

  20. Agnieszka Jurek Paweł, Krzesiński G, Gielerak, et al. Increased thoracic fluid as the most distinctive Cardiovascular hemodynamic alteration in men with Prolactinoma. Nutrients. 2022;14(24):5369. https://doi.org/10.3390/nu14245369

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Richter-Laskowska IKM, Feige D, et al. An effective method of detecting characteristic points of Impedance Cardiogram verified in the clinical pilot study. Sens (Basel). 2022;22(24):9872. https://doi.org/10.3390/s22249872

    Article  Google Scholar 

  22. Piccirillo G, Moscucci F, Corrao A, et al. Noninvasive hemodynamic monitoring in Advanced Heart failure patients: New Approach for Target treatments. Biomedicines. 2022;10(10):2407. https://doi.org/10.3390/biomedicines10102407

    Article  PubMed  PubMed Central  Google Scholar 

  23. Małgorzata K, Krzesiński Paweł, Gielerak G, et al. Cardiopulmonary exercise testing and impedance cardiography in the assessment of exercise capacity of patients with coronary artery disease early after myocardial revascularization. BMC Sports Sci Med Rehabil. 2022;14(1):134. https://doi.org/10.1186/s13102-022-00527-w

    Article  Google Scholar 

  24. César C, Mahajan S, Gu Jlei et al. Hemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography. PLoS One, 2022;17(6): e 0269777. https://doi.org/10.1371/journal.pone.0269777. e Collection 2022.

  25. Parrott CW, Burnham KM, Quale C, et al. Comparison of changes in ejection fraction to changes in impedance cardiography cardiac index and systolic time ratio. Congest Heart Failure. 2004;10(2 suppl 2):11–3. https://doi.org/10.1111/j.1527-5299.2004.03407.x

    Article  Google Scholar 

  26. Erifyli Piastopoulou P, Ali G, Bertelli, et al. Comparison of impedance cardiography and cardiac magnetic resonance imaging for the evaluation of cardiac function in early-stage breast cancer patients. Physiol Meas. 2021;42(10). https://doi.org/10.1088/1361-6579/ac28e5

  27. Kang Liu Zke, Qin Y, Ge, et al. Acute kidney injury in advanced lung cancer patients treated with PD-1 inhibitors: a single center observational study. J Cancer Res Clin Oncol. 2022 Nov;3. https://doi.org/10.1007/s00432-022-04437-9

  28. Salahudeen AK, Doshi SM, Pawar T, Nowshad G, Lahoti A, Shah P. Incidence rate, clinical correlates, and outcomes of AKI in patients admitted to a comprehensive cancer center. Clin J Am Soc Nephrol. 2013;8:347–54. https://doi.org/10.2215/CJN.03530412. Epub 2012 Dec 14.

    Article  PubMed  Google Scholar 

  29. Chertow GM, Burdick E, Honour M, et al. Acute kidney Injury, mortality, length of Stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005;16:3365–70. https://doi.org/10.1681/ASN.2004090740. Epub 2005 Sep 21.

    Article  PubMed  Google Scholar 

  30. Fang Y, Ding Xqiang, Zhong Y, et al. Acute kidney Injury in a Chinese Hospitalized Population. Blood Purif. 2010;30:120–6. https://doi.org/10.1159/000319972. Epub 2010 Aug 14.

    Article  PubMed  Google Scholar 

  31. Uchino S, Kellum JA, Bellomo R, et al. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294:813–8. https://doi.org/10.1001/jama.294.7.813

    Article  PubMed  CAS  Google Scholar 

  32. Hoste EA, Schurgers M. Epidemiology of acute kidney injury: how big is the problem? Crit Care Med. 2008;36(4 Suppl). https://doi.org/10.1097/CCM.0b013e318168c590. S146-51.

  33. Maccariello E, Valente C, Nogueira L, et al. Outcomes of cancer and non-cancer patients with acute kidney injury and need of renal replacement therapy admitted to general intensive care units. Nephrol Dial Transplant. 2011;26:537–43. https://doi.org/10.1093/ndt/gfq441.Epub2010Jul28

    Article  PubMed  Google Scholar 

  34. Van De Water JM, Miller TW, Vogel RL, et al. Impedance cardiography: the next vital sign technology. Chest. 2003;123(6):2028–33. https://doi.org/10.1378/chest.123.6.2028

    Article  PubMed  Google Scholar 

  35. Sageman WS, Riffenburgh RH, Spiess BD. Equivalence of bioimpedance and thermodilution in measuring cardiac index after cardiac surgery. J Cardiothorac Vasc Anesth. 2002;16(1):8–14. https://doi.org/10.1053/jcan.2002.29635

    Article  PubMed  Google Scholar 

  36. Darmon M, Thiery G, Ciroldi M, et al. Should dialysis be offered to cancer patients with acute kidney injury? Intensive Care Med. 2007;33:765–72. https://doi.org/10.1007/s00134-007-0579-1. Epub 2007 Mar 7.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Not applicable.

Funding

This research was funded by the 2023 key subject of medical science research in Hebei Province(20230112).

Author information

Authors and Affiliations

  1. The Fourth Hospital of Hebei Medical University, Department of Nephrology, Hebei Key Laboratory of Vascular Calcification in Kidney Disease, Hebei Clinical Research Center for Chronic Kidney Disease, 12 Jian kang Road, Shijiazhuang, 050011, P.R. China

    Huihui Chen, Lei He, Wei Zhou, Shenglei Zhang, Zhe zhe Niu, Jingjing Jin, Mei juan Cheng, Liping Guo, Xiang nan Liang, Rong fang Zhu, Huiran Zhang, Yaling Bai & Jin sheng Xu

  2. Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, P.R. China

    Guolei Zhang

Authors
  1. Huihui Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guolei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lei He
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wei Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shenglei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zhe zhe Niu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jingjing Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mei juan Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Liping Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Xiang nan Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Rong fang Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Huiran Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Yaling Bai
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Jin sheng Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Jin sheng Xu. designed the study；Huihui Chen. contributed to data collection, conducted statistical analyses, and wrote the manuscript; Yaling Bai, Guolei Zhang, Lei He, Wei Zhou, Shenglei Zhang, Zhe zhe Niu, Jingjing JIN, Mei juan Cheng, Liping Guo, Xiang nan Liang, Rong fang Zhu, Huiran Zhang. contributed to data collection and revised the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Jin sheng Xu.

Ethics declarations

Ethical approval and consent to participate

All procedures performed in studies involving human subjects comply with institutional and/or national ethical standards, Research Council and the 1964 Declaration of Helsinki and its later amendments or similar ethical standards. The study was evaluated and approved by the Ethics Committee of the Fourth Hospital of Hebei Medical University (2021KY044) with informed consent from all participants included in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, H., Zhang, G., He, L. et al. Effect of cardiac function in patients with gastrointestinal cancer with or without acute kidney injury assessed using a non-invasive impedance cardiography: a case-control study. BMC Cardiovasc Disord 23, 490 (2023). https://doi.org/10.1186/s12872-023-03533-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12872-023-03533-z

Keywords

BMC Cardiovascular Disorders

ISSN: 1471-2261

Contact us