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Association of pulse wave velocity with vascular and valvular calcification in hemodialysis patients

P Raggi1, A Bellasi, E Ferramosca

  • 1Division of Cardiology and Department of Radiology, Emory University School of Medicine, Atlanta, Georgia 30322, USA, and Department of Nephrology, Ospedale San Paolo, Milan, Italy. praggi@emory.edu

Kidney International
|February 22, 2007
PubMed

Insights

Plain abdominal X-rays effectively predict arterial stiffness in hemodialysis patients. This finding, linked to cardiovascular calcification, may help anticipate sudden death and heart failure risks.

Area of Science:

  • Nephrology
  • Radiology
  • Cardiovascular Medicine

Background:

  • Kidney Disease: Improving Quality Outcomes (KDIGO) guidelines recommend investigating radiological methods for cardiovascular calcification assessment and arterial stiffness.
  • Arterial stiffness is a significant predictor of mortality in hemodialysis patients.

Purpose of the Study:

  • To investigate the association between various radiological methods of cardiovascular calcification and arterial stiffness (aortic pulse wave velocity - PWV).
  • To determine the predictive value of different calcification assessments for PWV in maintenance hemodialysis patients.

Main Methods:

  • 131 adult maintenance hemodialysis patients underwent assessment of aortic PWV.
  • Echocardiography (cardiac valve calcification), computed tomography (coronary artery and thoracic aorta calcium), and plain abdominal X-ray (abdominal aorta calcification score) were performed within one week.
  • Multivariable analysis was used to adjust for confounding factors.

Main Results:

  • Mean PWV increased with higher coronary artery, thoracic aorta, and abdominal aorta calcium scores (P<0.05).
  • Abdominal aorta calcification on plain X-ray showed a significant association with PWV after multivariable adjustment (P=0.004).
  • Associations between PWV and thoracic aorta/coronary artery calcification were marginal (P=0.308, P=0.083). No association was found with valve calcification.

Conclusions:

  • Abdominal aorta calcification assessed by plain X-ray is strongly associated with arterial stiffness (PWV) in hemodialysis patients.
  • Plain X-ray assessment of aortic calcification may help predict increased arterial stiffness, a risk factor for sudden death and heart failure in this population.

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