title: Impact of chronic kidney disease on the presence and severity of aortic stenosis in patients at high risk for coronary artery disease.
abstract: OBJECTIVE
  We evaluated the impact of chronic kidney disease (CKD) on the presence and severity of aortic stenosis (AS) in patients at high risk for coronary artery disease (CAD).
  
  
  METHODS
  One hundred and twenty consecutive patients who underwent invasive coronary angiography were enrolled. Aortic valve area (AVA) was calculated by the continuity equation using transthoracic echocardiography, and was normalized by body surface area (AVA index).
  
  
  RESULTS
  Among all 120 patients, 78% had CAD, 55% had CKD (stage 3: 81%; stage 4: 19%), and 34% had AS (AVA < 2.0 cm²). Patients with AS were older, more often female, and had a higher frequency of CKD than those without AS, but the prevalence of CAD and most other coexisting conventional risk factors was similar between patients with and without AS. Multivariate linear regression analysis indicated that only CKD and CAD were independent determinants of AVA index with standardized coefficients of -0.37 and -0.28, respectively. When patients were divided into 3 groups (group 1: absence of CKD and CAD, n = 16; group 2: presence of either CKD or CAD, n = 51; and group 3: presence of both CKD and CAD, n = 53), group 3 had the smallest AVA index (1.19 ± 0.30*# cm²/m², *p < 0.05 vs. group 1: 1.65 ± 0.32 cm²/m², and #p < 0.05 vs. group 2: 1.43 ± 0.29* cm²/m²) and the highest peak velocity across the aortic valve (1.53 ± 0.41*# m/sec; *p < 0.05 vs. group 1: 1.28 ± 0.29 m/sec, and #p < 0.05 vs. group 2: 1.35 ± 0.27 m/sec).
  
  
  CONCLUSIONS
  CKD, even pre-stage 5 CKD, has a more powerful impact on the presence and severity of AS than other conventional risk factors for atherosclerosis in patients at high risk for CAD.
authors.affiliation: Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Masuda
authors.forename: Kaoru
authors.initials: K
authors.lastname: Dohi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sakurai
authors.forename: Yuri
authors.initials: Y
authors.lastname: Bessho
authors.forename: Harumi
authors.initials: H
authors.lastname: Fukuda
authors.forename: Shinobu
authors.initials: S
authors.lastname: Fujii
authors.forename: Tadafumi
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Masaki
authors.initials: M
authors.lastname: Tanabe
authors.forename: Katsuya
authors.initials: K
authors.lastname: Onishi
authors.forename: Katsuya
authors.initials: K
authors.lastname: Shiraki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nobori
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors
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