title: Coronary artery calcification progression is associated with arterial stiffness and cardiac repolarization deterioration in hemodialysis patients.
abstract: OBJECTIVE
  Evidence suggests that vascular calcification (VC) portends poor cardiovascular (CV) prognosis in patients undergoing maintenance dialysis (CKD-5). Nonetheless, how VC might predispose to CV mortality still remains to be clarified. Herein, we report on the association between coronary artery calcification (CAC) progression and changes in cardiac repolarization as well as arterial stiffness.
  
  
  METHODS
  132 patients new to dialysis were identified. Demographic and clinical characteristics were collected at study entry and during the 12-month follow-up. CAC, 12-lead ECG and pulse wave velocity (PWV) were assessed at baseline and study completion. Uni- and multivariable analyses were applied to detect factors associated with worsening of cardiac repolarization (QTd) and arterial stiffness (PWV).
  
  
  RESULTS
  Uni- and multivariable analyses revealed that CAC progression was associated with a significant increase in both QTd and PWV. Every 20-unit increase in the CAC score corresponded to a significant 23% (95% CI 1.12-1.27; p < 0.001) and 32% (95% CI 1.09-1.37; p < 0.01) increase in the risk of experiencing a 1-m/s increase in PWV and 1 ms in QTd, respectively.
  
  
  CONCLUSIONS
  VC is a marker of vasculopathy and appears to be associated with cardiac repolarization and arterial stiffness abnormalities in CKD-5 patients.
authors.affiliation: UO di Nefrologia, PO A Landolfi, Via Melito snc, Solofra, Italy. br.diiorio@gmail.com
authors.forename: Biagio
authors.initials: B
authors.lastname: Di Iorio
authors.forename: Onorio
authors.initials: O
authors.lastname: Nargi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cucciniello
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bellizzi
authors.forename: Serena
authors.initials: S
authors.lastname: Torraca
authors.forename: Domenico
authors.initials: D
authors.lastname: Russo
authors.forename: Antonio
authors.initials: A
authors.lastname: Bellasi
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000473:pathology; D001774:Blood Chemical Analysis; D002114:Calcinosis / Q000473:pathology*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000503:physiopathology; D018450:Disease Progression; D004562:Electrocardiography; D055724:Electrophysiological Phenomena; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors