Aortic arch calcification and arterial stiffness are independent factors for diastolic left ventricular dysfunction in chronic hemodialysis patients.
BACKGROUND
Because cardiovascular disease is the major cause of death in dialysis patients, the correlation between diastolic left ventricular (LV) dysfunction and arterial sclerosis, including thoracic aortic calcification, was studied in chronic hemodialysis (HD) patients.


RESULTS
The enrolled study subjects were 142 (73 men, 69 women) maintenance HD patients. Aortic arch calcification volume (AoACV) was measured by MDCT scan, arterial stiffness was estimated by brachial-ankle pulse wave velocity (PWV) and diastolic LV function was estimated as E/E' by tissue Doppler imaging with cardiac ultrasonography. E/E' correlated significantly with systolic blood pressure (r=0.29, p=0.037), age (r=0.19, p=0.02), LV mass index (r=0.18, p=0.036), dialysis vintage (r=0.19, p=0.037), AoACV (r=0.37, p<0.0001) and PWV (r=0.33, p=0.0002). Multiple regression analysis indicated that AoACV (beta=0.26, p=0.005) and PWV (beta=0.22, p=0.03) were independent determinants of E/E'.


CONCLUSIONS
Diastolic LV dysfunction may be induced by increased vascular calcification and reduced arterial stiffness in chronic HD patients.
Fujiu
Ayuko
A
Department of Medicine, Kidney Center, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
Ogawa
Tetsuya
T
Matsuda
Nami
N
Ando
Yoshitaka
Y
Nitta
Kosaku
K
D000368:Aged; D001013:Aorta, Thoracic / Q000473:pathology / Q000503:physiopathology*; D001018:Aortic Diseases / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002114:Calcinosis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D003971:Diastole; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*