Accelerated progression and morbidity in patients with aortic stenosis on chronic dialysis.
BACKGROUND
Progression of aortic stenosis (AS) influences the prognosis in chronic dialysis (CD) patients, but there have been few studies in Japanese patient populations.


RESULTS
The progression of AS was examined in 16 CD patients (68+/-10 years) and 82 non-dialysis patients (73+/-11 years). The mean follow-up was 32 and 40 months, respectively. The calcium-phosphate product was increased in CD patients (49+/-14 mg/dl vs 30+/-5 mg/dl; p<0.0001). At entry, the peak transaortic gradient detected by Doppler echocardiography was lower in CD patients (42+/-12 mmHg vs 57+/-22 mmHg; p<0.05). At follow-up, there was no difference between the 2 groups in that value (69+/-31 mmHg vs 71+/-27 mmHg). Decreasing rate of calculated aortic valvular area was increased in CD patients (0.14+/-0.13 cm2/year vs 0.06+/-0.09 cm2/year; p<0.05) and the calcification of the aortic valve was more severe at follow up in CD patients. The mortality was higher in CD patients (75 vs 28%; p<0.001).


CONCLUSIONS
AS appeared to progress rapidly in CD patients and therefore early aortic valve replacement may be necessary.
Ohara
Takahiro
T
Department of Cardiology, Kameda Medical Center, Kamogawa, Chiba, and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Japan.
Hashimoto
Yuji
Y
Matsumura
Akihiko
A
Suzuki
Makoto
M
Isobe
Mitsuaki
M
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology; D001024:Aortic Valve Stenosis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D002114:Calcinosis / Q000209:etiology; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies
D002784:Cholesterol