Cardiac valve calcification by echocardiography predicts coronary artery calcium scores in dialysis patients

doi:10.3877/cma.j.issn.1672-6448.2015.10.011

Abstract

Abstract:

Objective

To determine whether cardiac valve calcification on echocardiography could predict coronary artery calcium scores (CACS) in hemodialysis patients.

Methods

This was a cross-sectional study of 169 stage V hemodialysis patients. The presence of calcification of the cardiac valves was assessed by echocardiography. All patients underwent multi-slice spiral computed tomography for quantification of CACS. According to CACS, they were divided into 3 groups (11-100, 101-400, and≥400). According to cardiac valve calcification, they were divided into 4 groups: no valve calcification, aortic valve calcification, mitral valve calcification and aotic/mitral valve calcification. Logistic regression was used to calculate the odds ratios (ORs) of having a CACS greater than 10, 100 and 400 in presence of valve calcification.

Results

Eighty-eight patients (52.07%) had echocardiographic evidence of valvular calcification. Patients with aortic valve calcification, mitral valve calcification and aotic/mitral valve calcification had a significantly greater likelihood of having CACS≥400 [OR=4.61, 95% confidence interval (95%CI) 1.22-17.4, P=0.02; OR = 5.31, 95%CI 1.37-20.5, P=0.01; OR = 16.94, 95%CI 5.16-55.58, P=0.001].

Conclusions

The cardiac valve calcification in hemodialysis patients was strongly associated with the presence and degree of CACS independently of clinical risk factors. Echocardiography is a useful method to predict CACS in hemodialysis patients by detecting cardiac valve calcification.

Key words: Renal dialysis, Heart valves, Echocardiography, stress

Mingxia Li, Bin Yang, Juan Li, Yun Dai, Xiaochun Wang, Hui Sun, Hong Wang. Cardiac valve calcification by echocardiography predicts coronary artery calcium scores in dialysis patients[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(10): 792-797.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2015.10.011

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References 23

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组别	例数	透析时间（年）	血清钙（mmol/L）	血磷（mmol/L）	iPTH（ng/L）	BMI（kg/m²）	尿素氮（mmol/L）
无瓣膜钙化组	81	5.6±4.7	2.4±0.2	1.6±0.5	522±550	21.7±3.0	70.5±16.3
瓣膜钙化组	88	7.3±6.4	2.4±0.2	1.6±0.5	388±463	23.1±3.9	67.3±16.8
t值	?	-1.791	-1.177	0.244	-0.550	-0.342	-0.429
P值	?	0.05	0.98	0.73	0.01	0.006	0.21
组别	例数	肌酐（mmol/L）	血糖（mmol/L）	总胆固醇（mmol/L）	LDL（mmol/L）	HDL（mmol/L）	三酰甘油（mmol/L）
无瓣膜钙化组	81	9.8±3.1	5.3±2.8	4.8±0.9	2.4±0.7	0.9±0.3	1.8±1.4
瓣膜钙化组	88	10.5±3.4	5.2±1.2	4.7±1.0	2.4±0.7	0.9±0.4	1.6±0.9
t值	?	0.913	0.826	0.242	-0.059	-0.410	0.980
P值	?	0.18	0.67	0.37	0.54	0.81	0.41

组别	例数	透析时间（年）	血清钙（mmol/L）	血磷（mmol/L）	iPTH（ng/L）	BMI（kg/m²）	尿素氮（mmol/L）
无瓣膜钙化组	81	5.6±4.7	2.4±0.2	1.6±0.5	522±550	21.7±3.0	70.5±16.3
瓣膜钙化组	88	7.3±6.4	2.4±0.2	1.6±0.5	388±463	23.1±3.9	67.3±16.8
t值	?	-1.791	-1.177	0.244	-0.550	-0.342	-0.429
P值	?	0.05	0.98	0.73	0.01	0.006	0.21
组别	例数	肌酐（mmol/L）	血糖（mmol/L）	总胆固醇（mmol/L）	LDL（mmol/L）	HDL（mmol/L）	三酰甘油（mmol/L）
无瓣膜钙化组	81	9.8±3.1	5.3±2.8	4.8±0.9	2.4±0.7	0.9±0.3	1.8±1.4
瓣膜钙化组	88	10.5±3.4	5.2±1.2	4.7±1.0	2.4±0.7	0.9±0.4	1.6±0.9
t值	?	0.913	0.826	0.242	-0.059	-0.410	0.980
P值	?	0.18	0.67	0.37	0.54	0.81	0.41

相关危险因素	标准回归系数	95%可信区间	P值
年龄	0.05	1.00~1.11	0.007
总胆固醇	5.39	1.32~22.1	0.019
三酰甘油	0.23	0.07~0.67	0.008
LDL	0.18	0.04~0.80	0.024
BMI	1.31	1.07~1.60	0.008
性别	0.08	0.17~0.42	0.003

相关危险因素	标准回归系数	95%可信区间	P值
年龄	0.05	1.00~1.11	0.007
总胆固醇	5.39	1.32~22.1	0.019
三酰甘油	0.23	0.07~0.67	0.008
LDL	0.18	0.04~0.80	0.024
BMI	1.31	1.07~1.60	0.008
性别	0.08	0.17~0.42	0.003

相关危险因素	β系数	95%可信区间	P值
瓣膜钙化	1.02	0.46~1.57	0.001
年龄	0.05	0.001~0.10	0.049
iPTH	1.36	0.01~2.73	0.043

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