Key result
Cardiac valve calcification in long-term hemodialysis patients was associated with worse left ventricular longitudinal systolic function compared to those without calcification (GLS -0.18 vs -0.25; p<0.01).
Why the study?
Does the presence of cardiac valve calcification correlate with early left ventricular dysfunction in long-term hemodialysis patients with normal LVEF?
Cross-Sectional (n=47)
Does the presence of cardiac valve calcification correlate with early left ventricular dysfunction in long-term hemodialysis patients with normal LVEF?
Absolute Event Rate: -0.18% vs -0.25%
p-value: p=<0.01
In long-term hemodialysis patients with normal LVEF, cardiac valve calcification is associated with early subclinical left ventricular systolic and diastolic dysfunction detectable by speckle tracking echocardiography.
Valve calcification may flag subclinical LV dysfunction in hemodialysis patients with normal LVEF; hypothesis-generating and requires prospective validation.
PURPOSE: Cardiac valve calcification (VC) is very common in patients on hemodialysis. However, the definite effect of VC on left ventricular (LV) geometry and function in this population is unknown, especially when LV ejection fraction (LVEF) is normal. The aim of this study was to determine the effect of VC on LV geometry and function in long-term hemodialysis patients by conventional echocardiography and two-dimensional speckle tracking echocardiography (2D-STE). METHODS: A total of 47 hemodialysis patients (2-3 times weekly for 5 years or more) were enrolled in this study. Cardiac VC was defined as bright echoes of more than 1 mm on one or more cusps of the aortic valve or mitral valve or mitral annulus using echocardiography as the screening method. LV longitudinal global strain (GLS) was assessed on the apical four-chamber view and calculated as the mean strain of 6 segments. LV global circumferential strain was acquired on the LV short axis view at the level of papillary muscles. RESULTS: Twenty-five patients with VC had higher mean values of interventricular septum thickness, LV posterior wall thickness, LV mass index, relative wall thickness, and LV mass/end-diastolic volume than 22 patients without VC (p < 0.05, respectively), indicating more obvious LV hypertrophy (LVH). VC patients had higher mitral annular E/E' values, especially at the septal side representing increased LV filling pressure compatible with diastolic dysfunction, while only the E/E' ratio of the septal side was significantly different between the 2 groups (16.7 ± 4.1 vs. 12.3 ± 4.4, p < 0.01). When assessed by GLS, LV longitudinal systolic function was also lower in in patients with VC compared with those without VC (-0.18 ± 0.03 vs. -0.25 ± 0.04; p < 0.01). CONCLUSIONS: Cardiac VC diagnosed by echocardiography when it occurs in long-term hemodialysis patients may indicate more severe LVH, myocardial damage, and worse heart function in comparison to those without VC. Tissue Doppler imaging and 2D-STE can detect the subtle change of heart function in this population in the early stage of LV dysfunction when LVEF is normal.
No takes yet. Share an insight, caveat, or question.
Li et al. (2018) conducted a cross-sectional in Long-term hemodialysis (n=47). Cardiac valve calcification vs. No cardiac valve calcification was evaluated on Left ventricular longitudinal global strain (GLS) (p=<0.01). Cardiac valve calcification in long-term hemodialysis patients was associated with worse left ventricular longitudinal systolic function compared to those without calcification (GLS -0.18 vs -0.25; p<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: