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Prognosis of Heart Valve Calcification on Cardiovascular Events in Hemodialysis Patients without Central Venous

Xiao-Mei Huang1, Yi Zhang2, Min Du3

  • 1Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Cardiorenal Medicine
|February 1, 2023
PubMed

Insights

Heart valvular calcification (HVC) predicts cardiovascular events (CEs) in hemodialysis (HD) patients. Even after accounting for early HD stage and central venous catheters (CVC), HVC remains a significant risk factor for adverse CEs.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Medicine

Background:

  • Heart valvular calcification (HVC) is a known predictor of cardiovascular events (CEs) and mortality in dialysis patients.
  • Patients in early hemodialysis (HD) stages or with central venous catheters (CVC) face elevated risks, potentially confounding HVC prognosis.

Purpose of the Study:

  • To investigate the prognostic value of HVC on cardiovascular events (CEs) and all-cause mortality in long-term hemodialysis (HD) patients.
  • To determine if HVC remains an independent predictor of adverse outcomes after excluding confounding factors like early HD stage and CVC use.

Main Methods:

  • Retrospective study of 158 hemodialysis (HD) patients with arteriovenous access, followed from March 2017 to April 2022.
  • Echocardiography used to diagnose HVC; cardiovascular events (CEs) and all-cause mortality were recorded.
  • Multivariate COX regression analysis employed to identify risk factors for CEs.

Main Results:

  • HVC was diagnosed in 44.3% of patients; 180 CEs occurred, with acute heart failure being the most common (62.66%).
  • CE-free survival was significantly lower in the HVC group (p = 0.030).
  • HD vintage, mitral valve calcification, and aortic valve regurgitation/stenosis were risk factors for CE; no significant difference in all-cause mortality was observed between HVC groups (p = 0.560).

Conclusions:

  • Heart valvular calcification (HVC) is a significant predictor of adverse cardiovascular events (CEs) in hemodialysis (HD) patients.
  • Even after adjusting for early HD stage and central venous catheter (CVC) use, HVC independently predicts CEs.
  • Mitral valve calcification and aortic valve abnormalities are key risk factors for CEs in this population.
Abstract

Keywords:
All-cause mortalityAortic valve calcificationCardiovascular eventsHeart valvular calcificationHemodialysisMitral valve calcification

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