ArticleBMC medicine2023
Assessment of cardio-renal-hepatic function in patients with valvular heart disease: a multi-biomarker approach-the cardio-renal-hepatic score.
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Multidimensional Physiological and Gut Microbiome Profiling Identifies Subtle Physiological Patterns in an Apparently Healthy Aging Indian Cohort: A Cross-Sectional Observational Study.Microorganisms · 2026Article
- Impact of RAS inhibitors on 2-year mortality and disease progression in chronic mitral regurgitation.BMC cardiovascular disorders · 2026Article
- Uromodulin as a genetically anchored biomarker stratifies time to valve intervention in aortic regurgitation.Frontiers in cardiovascular medicine · 2026Article
- Cardiovascular-Renal-Hepatic-Metabolic Syndrome: Interlinked Pathophysiology and Integrated Management Approach.Cureus · 2025Review
- Nonlinear association between serum albumin levels and all-cause mortality in elderly patients with chronic aortic regurgitation.Journal of geriatric cardiology : JGC · 2025Article
- Prognostic Impact of Anemia in Patients with Significant Mitral Regurgitation: A Multicenter Cohort Study.International journal of general medicine · 2025Article
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18 authors at 1 institution in 1 country.
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Abstract
backgroundValvular heart disease (VHD) can cause damage to extra-cardiac organs, and lead to multi-organ dysfunction. However, little is known about the cardio-renal-hepatic co-dysfunction, as well as its prognostic implications in patients with VHD. The study sought to develop a multi-biomarker index to assess heart, kidney, and liver function in an integrative fashion, and investigate the prognostic role of cardio-renal-hepatic function in VHD.
methodsUsing a large, contemporary, prospective cohort of 6004 patients with VHD, the study developed a multi-biomarker score for predicting all-cause mortality based on biomarkers reflecting heart, kidney, and liver function (N-terminal pro-B-type natriuretic peptide [NT-proBNP], creatinine, and albumin). The score was externally validated in another contemporary, prospective cohort of 3156 patients with VHD.
resultsDuring a median follow up of 731 (704-748) days, 594 (9.9%) deaths occurred. Increasing levels of NT-proBNP, creatinine, and albumin were independently and monotonically associated with mortality, and a weighted multi-biomarker index, named the cardio-renal-hepatic (CRH) score, was developed based on Cox regression coefficients of these biomarkers. The CRH score was a strong and independent predictor of mortality, with 1-point increase carrying over two times of mortality risk (overall adjusted hazard ratio [95% confidence interval]: 2.095 [1.891-2.320], P < 0.001). The score provided complementary prognostic information beyond conventional risk factors (C index: 0.78 vs 0.81; overall net reclassification improvement index [95% confidence interval]: 0.255 [0.204-0.299]; likelihood ratio test P < 0.001), and was identified as the most important predictor of mortality by the proportion of explainable log-likelihood ratio χ
conclusionsA multi-biomarker index was developed to assess cardio-renal-hepatic function in patients with VHD. The cardio-renal-hepatic co-dysfunction is a powerful predictor of mortality and should be considered in clinical management decisions.
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