Related Experiment Video
Updated: Jun 15, 2026
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Coronary artery calcification and coronary flow velocity in haemodialysis patients
Yasar Caliskan1, Mustafa Demirturk, Abdullah Ozkok
1Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. ykcaliskan@yahoo.com
Insights
Coronary artery calcification scores (CACS) are linked to reduced coronary flow reserve (CFR) in hemodialysis patients, indicating increased cardiovascular risk. Higher CACS correlate with more cardiovascular events and mortality in this population.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Background:
- Decreased coronary flow reserve (CFR) signifies endothelial dysfunction and cardiovascular risks in hemodialysis (HD) patients.
- Coronary artery calcification (CAC) is a known cardiovascular risk factor in HD patients.
Purpose of the Study:
- To investigate the correlation between coronary artery calcification scores (CACS) and CFR in HD patients.
- To assess the predictive value of CACS for cardiovascular events in HD patients.
Main Methods:
- Sixty-four end-stage renal failure patients and 39 healthy controls were enrolled.
- Coronary artery calcification scores (CACS) were measured using electron beam computerized tomography.
- Coronary flow reserve (CFR) was assessed by trans-thoracic Doppler echocardiography.
Main Results:
- Patients with CACS > 10 had significantly lower CFR values compared to those with CACS < 10 (P = 0.024).
- CFR was negatively correlated with CACS (r = -0.276, P = 0.030), with CACS being an independent predictor of CFR.
- Patients with CACS > 10 exhibited a higher rate of cardiovascular events (34.5% vs 0%, P = 0.001) and mortality during 18-month follow-up.
Conclusions:
- Coronary artery calcification scores (CACS) are associated with coronary flow reserve (CFR) in hemodialysis patients.
- This association suggests shared pathophysiology of the arterial system in HD patients, reflecting both anatomical and functional aspects.
- Inflammation markers (hs-CRP) did not show a significant association with CACS or CFR in this cohort.
Background:
Decreased coronary flow reserve (CFR) is a marker of endothelial dysfunction, coronary artery calcification and inflammation, well-known cardiovascular risk factors in haemodialysis (HD) patients. In this study, we aimed to investigate the correlation of coronary artery calcification scores (CACS) with CFR in HD patients.
Methods:
Sixty-four end-stage renal failure patients were enrolled in this study (38 males, 26 females). Thirty-nine healthy subjects (22 males, 17 females) were included in the control group. Biochemical parameters and acute-phase inflammation marker [high-sensitivity C-reactive protein (hs-CRP)] of patients were recorded before dialysis. The CACS were measured by electron beam computerized tomography method. CFR recordings were performed by trans-thoracic Doppler echocardiography. The relationship between CACS and CFR was evaluated.
Results:
The mean CACS was 281 +/- 589 and 29 patients had CACS < 10. Patients with CACS > 10 had significantly lower CFR values compared to patients with CACS < 10 (1.56 +/- 0.38 vs 1.84 +/- 0.53, P = 0.024). However, there was no difference in hs-CRP values between the groups. CFR was negatively correlated with CACS (r = -0.276, P = 0.030). In multiple stepwise regression analysis, CACS was found to be an independent variable for predicting CFR (P = 0.048). During a follow-up of 18 months, 10 patients had experience of cardiovascular events. Patients with CACS > 10 had significantly higher event rate [34.5% (10/29) vs 0% (0/24)] compared to those with CACS < 10 (P = 0.001). Patients who developed cardiovascular events had significantly higher mean CACS and lower CFR values than the remaining group (P = 0.019 and P = 0.039). All of four patients who died during follow-up were in the CFR < 2 and CACS > 10 groups.
Conclusions:
CACS was associated with CFR in HD patients. However, we did not find any association of inflammation with CACS and CFR. This association between CFR and CACS might indicate two different (anatomical and functional) aspects of the common pathophysiology of the arterial system in HD patients.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:24Hemodialysis II: Procedure and Complications
01:25Hemodialysis I: Introduction
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
01:25Hemodialysis III: Nursing Management
01:22Renal Drug Excretion: Effect of Urine pH, Flow Rate, and Drug pKa
The pKa of a drug,...