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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Cardiovascular Calcifications Are Correlated with Inflammation in Hemodialysis Patients
Dorin Dragoș1,2, Delia Timofte3, Mihai-Teodor Georgescu1,4
1Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Dionisie Lupu nr 37, Sect 2, 020021 Bucharest, Romania.
Insights
Cardiovascular disease is common in hemodialysis patients. This study found inflammation and poor nutrition are linked to vascular calcifications and increased mortality risk in these patients.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Biochemistry
Background:
- Cardiovascular disease (CVD) is a leading cause of death in hemodialysis (HD) patients.
- Vascular and valvular calcifications are common complications in HD patients.
- Oxidative stress and inflammation play significant roles in CVD pathogenesis.
Purpose of the Study:
- To investigate the relationship between oxidative stress, inflammation, and vascular/valvular calcifications in HD patients.
- To explore correlations between atherosclerosis markers, nutritional status, and mortality risk.
Main Methods:
- Observational study of 54 hemodialysis patients.
- Cardiovascular ultrasound and plain radiography for calcification and plaque assessment.
- Analysis of inflammatory markers (IL-6, TNF-α), oxidative stress, metabolic, and dietary parameters.
Main Results:
- Interleukin-6 (IL-6) levels correlated with carotid plaque number and aortic calcification score.
- Tumor necrosis factor-alpha (TNF-α) showed inverse correlations with aortic annulus calcifications and intima-media thickness.
- Nutritional markers like albumin and BMI were negatively correlated with atherosclerosis markers.
- Age and atherosclerosis markers (carotid plaques, femoral plaques, aortic calcifications) were positively associated.
- Aortic annulus calcifications, aortic valve calcifications, and mitral valve calcifications were linked to increased mortality risk.
Conclusions:
- Imaging markers of atherosclerosis in HD patients are associated with inflammation and poorer nutritional status.
- These atherosclerosis markers are also positively correlated with an increased risk of mortality.
- Findings highlight the interplay between inflammation, nutrition, calcification, and outcomes in hemodialysis patients.
Abstract:
Background and Objectives: The main cause of morbidity and mortality in hemodialysis patients is cardiovascular disease, which is quite common. The main objective of our study was to investigate the relationship between oxidative stress, inflammation, and vascular and valvular calcifications in hemodialysis patients. Materials and Methods: This observational study had 54 hemodialysis patients, with an average age of 60.46 ± 13.18 years. Cardiovascular ultrasound was used to detect and/or measure aortic and mitral valve calcifications, carotid and femoral atheroma plaques, and common carotid intima-media thickness. The aortic calcification score was determined using a lateral abdomen plain radiograph. The inflammatory, oxidative, metabolic, and dietary statuses, as well as demographic characteristics, were identified. Results: There were significant correlations between the levels of IL-6 and carotid plaque number (p = 0.003), fibrinogen level and aortic valve calcifications (p = 0.05), intima-media thickness (p = 0.0007), carotid plaque number (p = 0.035), femoral plaque number (p = 0.00014), and aortic calcifications score (p = 0.0079). Aortic annulus calcifications (p = 0.03) and intima-media thickness (p = 0.038) were adversely linked with TNF-α. Nutrition parameters were negatively correlated with atherosclerosis markers: number of carotid plaques with albumin (p = 0.013), body mass index (p = 0.039), and triglycerides (p = 0.021); number of femoral plaques with phosphorus (0.013), aortic calcifications score with albumin (p = 0.051), intima-media thickness with LDL-cholesterol (p = 0.042). Age and the quantity of carotid plaques, femoral plaques, and aortic calcifications were linked with each other (p = 0.0022, 0.00011, and 0.036, respectively). Aortic annulus calcifications (p = 0.011), aortic valve calcifications (p = 0.023), and mitral valve calcifications (p = 0.018) were all associated with an increased risk of death. Conclusions: Imaging measures of atherosclerosis are adversely connected with dietary status and positively correlated with markers of inflammation and risk of mortality.
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