Association of aortic stiffness with abdominal vascular and coronary calcifications in patients with stage 3 and 4...

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Radiology

Background:

• Increased central (aortic) arterial stiffness is a risk factor for cardiovascular and renal diseases.
• Chronic kidney disease (CKD) may exacerbate aortic stiffness due to metabolic alterations, including vascular calcification (VC).
• Understanding the association between aortic stiffness and VC in CKD is crucial for risk stratification.

Purpose of the Study:

• To analyze the association of central aortic pressures and aortic stiffness with VC in the abdominal aorta (AAC) and coronary arteries (CAC) in CKD patients.
• To evaluate the diagnostic performance of aortic stiffness indices for predicting VC.

Main Methods:

• Eighty-seven patients with CKD stages 3-4 were included.
• Applanation tonometry was used to measure central aortic pressures and aortic stiffness (pulse wave velocity, Pv_c-f, and Pv_c-f index).
• AAC was assessed via radiography, and CAC via multidetector computed tomography. Regression analyses and ROC curves were employed.

Main Results:

• The Pv_c-f index was higher in CKD patients with diabetes mellitus (DM).
• Albuminuria and abdominal aortic calcification (AAC) score were independently associated with the Pv_c-f index.
• The Pv_c-f index independently predicted both AAC and coronary artery calcification (CAC), showing good diagnostic performance (AUCs 0.82 and 0.81, respectively).

Conclusions:

• In stage 3-4 CKD, particularly with coexisting DM, aortic stiffness (Pv_c-f index) is elevated.
• AAC and CAC are highly prevalent in this population and frequently coexist.
• The Pv_c-f index is a valuable, non-invasive tool for identifying patients with vascular calcification in the abdominal aorta and coronary arteries.