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Impact of an angulated aorto-septal relationship on cardio-cerebrovascular outcomes in patients undergoing
Takafumi Nakayama1,2,3, Junki Yamamoto1,3, Toshikazu Ozeki4
1Department of Cardiology, Masuko Memorial Hospital, Nagoya, Aichi, Japan.
Plos One
|February 23, 2024
Summary
An angulated aorto-septal angle (ASA) is a significant risk factor for cardiovascular and cerebrovascular events in hemodialysis patients. Lower ASA values (<119.4 degrees) indicate a higher risk of adverse outcomes, including death.
Area of Science:
- Cardiology
- Nephrology
- Vascular Medicine
Background:
- Aortic and valvular calcification are established risk factors for cardio-cerebrovascular events in hemodialysis patients.
- Aortic elongation due to calcification can lead to an angulated aorto-septal angle (ASA).
Purpose of the Study:
- To investigate the clinical impact of the aorto-septal angle (ASA) on cardio-cerebrovascular outcomes in patients undergoing hemodialysis.
- To determine if ASA is an independent predictor of adverse cardiovascular and cerebrovascular events.
Main Methods:
- Echocardiography was used to quantify the ASA in 306 hemodialysis patients.
- Aortic and mitral valve calcification scores were determined.
- Multivariable Cox proportional hazards analyses and Kaplan-Meier analysis were performed to assess outcomes.
Main Results:
- An increased ASA was independently associated with a reduced risk of cardio-cerebrovascular events (HR 0.69; P = 0.003).
- Lower ASA values (<119.4 degrees) were linked to a higher incidence of the primary endpoint (Log-rank P < 0.001).
- Left ventricular ejection fraction, left ventricular mass index, and aortic valve calcification score were also independent determinants of outcomes.
Conclusions:
- An angulated aorto-septal angle is an independent risk factor for cardio-cerebrovascular events and death in hemodialysis patients.
- ASA measurement may aid in risk stratification for this high-risk population.
