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Updated: May 5, 2026
Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Calcification of the thoracic aorta determined by three-dimensional computed tomography predicts cardiovascular
Nozomu Kamiura1, Kiyoko Yamamoto, Shioko Okada
1Department of Internal Medicine, Konan Hospital, Kobe, Japan.
Insights
Aortic calcification, measured by computed tomography, predicts cardiovascular disease in hemodialysis patients. This non-invasive method offers a valuable prognostic tool for identifying at-risk individuals.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Cardiovascular disease is the leading cause of mortality in patients undergoing dialysis.
- Vascular calcification significantly contributes to cardiovascular complications in this population.
- Existing methods for assessing coronary calcification are often costly and require specialized equipment.
Purpose of the Study:
- To evaluate the utility of computed tomography (CT) for determining aortic calcification.
- To assess aortic calcification as a prognostic marker for cardiovascular disease in dialysis patients.
- To establish a non-invasive imaging technique for risk stratification.
Main Methods:
- A cohort of 49 hemodialysis patients underwent CT with contrast medium.
- A calcification score (CS) was calculated as the ratio of vascular to thoracic aorta volume.
- Patients were monitored for major adverse cardiovascular events over a 3-year period.
Main Results:
- A high calcification score (CS) was significantly associated with increased cardiovascular events (p = 0.007).
- Male gender also showed a significant association with cardiovascular events (p = 0.009).
- Baseline CS emerged as a significant independent predictor of cardiovascular events via logistic regression analysis (p < 0.05).
Conclusions:
- Thoracic aortic calcification, quantified by 3D CT, serves as a reliable predictor of cardiovascular complications.
- This imaging approach provides a valuable, non-invasive tool for prognostication in hemodialysis patients.
- The findings support the integration of CT-based aortic calcification assessment into routine clinical practice for risk management.
Purpose:
In patients on dialysis, the most common cause of death is cardiovascular disease. This is caused, at least in part, by excessive vascular calcification. Studies that have examined coronary calcification have been published, but these measurements require expensive equipment. Here, we used computed tomography to determine aortic calcification and evaluated these data as prognostic markers for cardiovascular disease.
Methods:
Computed tomography with contrast medium was performed on 49 patients undergoing hemodialysis (29 males and 20 females; average age, 68.9 ± 11.0 years). A calcification score (CS) was defined as the ratio of the volume of vascular calcification to the volume of the thoracic aorta. All patients were monitored for cardiovascular end points, which included cerebral infarction or hemorrhage, myocardial infarction, electrocardiographic, or echocardiographic abnormalities that suggested myocardial ischemia, cardiac surgery, leg amputation, and hospitalization or death due to heart failure.
Results:
Patients were followed for 3 years, with 12 patients reaching the end point. Both high CS (p = 0.007) and male gender (p = 0.009) were significantly associated with cardiovascular events. In contrast, events were not related to age, dialysis duration, diabetes mellitus, smoking status, low-density lipoprotein cholesterol level, pulse-wave velocity, maximum intima-media thickness of the carotid artery wall, systolic blood pressure, or left ventricular hypertrophy. Multiple logistic regression analysis revealed that a high baseline CS was a significant predictor for cardiovascular events (p < 0.05).
Conclusions:
Calcification of the thoracic aorta determined by three-dimensional computed tomography predicts cardiovascular complications in patients on hemodialysis.
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