title: [Screening and risk factors of cardiac calcification in hemodialysis: contribution of ultra-fast multi-slice scanner and transthoracic echocardiography].
abstract: BACKGROUND
  Cardiovascular disease is the first leading cause of death in hemodialysis patients. In this population, cardiovascular calcifications occur at an earlier age and progress faster than in general population.
  
  
  METHODS
  In order to determine the prevalence and risk factors of cardiac calcifications, 49 patients on chronic hemodialysis were screened in the coronary arteries and cardiac valves by the 64 multi-slice ultra-fast CT and the transthoracic echocardiography. Different clinical and biological parameters were studied by the SPSS 10.0 statistical software to determine risk factors.
  
  
  RESULTS
  Cardiac calcifications were identified in 81.6% of cases in at least one of the two studied sites. The coronary artery involvement was more common than valvular and concerned 69.4% of cases. The mean Agatston coronary artery calcium score (ACACS) was 331.1 and 522.2 in coronary patients and was correlated to alteration of systolic function of LV (r=-0.287, P=0.045). The severity of CACS was positively correlated with age (r=0.332, P=0.02). Coronary calcifications were associated with cardiovascular risk common to those of the general population (age, male sex, systolic blood pressure, diabetes, history of ischemic heart disease), but also to a lesser quality of dialysis. Valvular calcifications were present in 49% of cases and were correlated with left ventricular hypertrophy (P=0.006). The exclusive involvement of the aortic valve was the most common valvular abnormality. Phosphocalcic and lipid parameters, levels of hemoglobin, CRP and uric acid did not predisposed to cardiac calcifications in our patients.
  
  
  CONCLUSIONS
  In hemodialysis patients, the pathogenesis of cardiovascular calcification is complex and cannot be attributed to a passive process. This process involves several factors that can promote or inhibit calcification. The new multi-slice ultra-fast scanner is a very sensitive method for topographic and quantitative assessment of coronary calcification and is a better alternative to invasive techniques.
  
  
  CONCLUSIONS
  Our study confirms the high prevalence of cardiac calcification in hemodialysis, and highlights the importance of early screening and treatment of predisposing factors.
authors.affiliation: Unité de dialyse, service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, 10100 Rabat, Maroc. Electronic address: meders@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: El Amrani
authors.affiliation: Service de néphrologie, dialyse, premier centre médico-chirurgical, Agadir, Maroc.
authors.forename: O
authors.initials: O
authors.lastname: Maoujoud
authors.affiliation: Service de néphrologie, dialyse, premier centre médico-chirurgical, Agadir, Maroc.
authors.forename: M
authors.initials: M
authors.lastname: Belarbi
authors.affiliation: Unité de dialyse, service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, 10100 Rabat, Maroc.
authors.forename: M R
authors.initials: MR
authors.lastname: El Farouki
authors.affiliation: Unité de dialyse, service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, 10100 Rabat, Maroc.
authors.forename: Y
authors.initials: Y
authors.lastname: Zajjari
authors.affiliation: Service de cardiologie, premier centre médico-chirurgical, Agadir, Maroc.
authors.forename: Y
authors.initials: Y
authors.lastname: Boukili
authors.affiliation: Service de cardiologie, premier centre médico-chirurgical, Agadir, Maroc.
authors.forename: H
authors.initials: H
authors.lastname: Bouzelmate
authors.affiliation: Service de cardiologie, premier centre médico-chirurgical, Agadir, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: Rbaibi
authors.affiliation: Service de radiologie, premier centre médico-chirurgical, Agadir, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: El Kharras
authors.affiliation: Service de radiologie, premier centre médico-chirurgical, Agadir, Maroc.
authors.forename: T
authors.initials: T
authors.lastname: Salahedine
authors.affiliation: Service de néphrologie, dialyse, premier centre médico-chirurgical, Agadir, Maroc.
authors.forename: M
authors.initials: M
authors.lastname: Asserraji
authors.affiliation: Unité de dialyse, service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, 10100 Rabat, Maroc.
authors.forename: M
authors.initials: M
authors.lastname: Benyahia
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
keywords: 64 barrettes; 64 slices; Calcifications coronaires; Calcifications valvulaires; Coronary calcification; Dépistage; Echocardiography; Facteurs de risque; Hemodialysis; Hémodialyse; Multi-slice CT; Risk factors; Scanner multi-coupe; Screening; Valvular calcifications; Échocardiographie