title: Abdominal aortic calcification is associated with diastolic dysfunction, mortality, and nonfatal cardiovascular events in maintenance hemodialysis patients.
abstract: This study evaluated the significance of aortic calcification index (ACI), an estimate of abdominal aortic calcification by plain abdominal computed tomography (CT), in terms of left ventricular (LV) diastolic dysfunction, mortality, and nonfatal cardiovascular (CV) events in chronic hemodialysis patients. Hemodialysis patients who took both an abdominal CT and echocardiography were divided into a low-ACI group (n = 64) and a high-ACI group (n = 64). The high-ACI group was significantly older, had a longer dialysis vintage and higher comorbidity indices, and more patients had a previous history of CV disease than the low-ACI group. The ACI was negatively correlated with LV end-diastolic volume or LV stroke volume, and was positively correlated with the ratio of peak early transmitral flow velocity to peak early diastolic mitral annular velocity (E/E' ratio), a marker of LV diastolic function. The E/E' ratio was independently associated with the ACI. The event-free survival rates for mortality and nonfatal CV events were significantly lower in the high-ACI group compared with those in the low-ACI group, and the ACI was an independent predictor for all-cause deaths and nonfatal CV events. In conclusion, ACI is significantly associated with diastolic dysfunction and predicts all-cause mortality and nonfatal CV events in hemodialysis patients.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, Incheon, Korea.
authors.forename: Hye Eun
authors.initials: HE
authors.lastname: Yoon
authors.forename: Sungjin
authors.initials: S
authors.lastname: Chung
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Whang
authors.forename: Yu Ri
authors.initials: YR
authors.lastname: Shin
authors.forename: Hyeon Seok
authors.initials: HS
authors.lastname: Hwang
authors.forename: Hyun Wha
authors.initials: HW
authors.lastname: Chung
authors.forename: Cheol Whee
authors.initials: CW
authors.lastname: Park
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Seok Joon
authors.initials: SJ
authors.lastname: Shin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002114:Calcinosis / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000150:complications*; D018572:Disease-Free Survival; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D006435:Renal Dialysis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology*