Key result
Chronic hemodialysis is linked to a ~6-fold higher rate of aortic valve sclerosis versus controls.
Why the study?
Cardiovascular morbidity is high in chronic haemodialysis patients and previous studies showed a relation between uraemia-associated inflammation and cardiovascular mortality, but the relation of chronic inflammation to ultrasonographic markers of atherosclerotic cardiac or vascular alterations was unclear.
Is chronic inflammation associated with aortic valve alterations and carotid intima media thickness in chronic haemodialysis patients?
Cross-Sectional (n=70)
Is chronic inflammation associated with aortic valve alterations and carotid intima media thickness in chronic haemodialysis patients?
Absolute Event Rate: 34% vs 6%
Chronic inflammation in haemodialysis patients is associated with aortic valve stenosis and cardiovascular events, but not with carotid wall thickening, suggesting different pathogenetic mechanisms.
Elevated aortic valve disease burden in dialysis warrants attention; leaves open inflammation's causal role and need for prospective trials.
AIMS: Cardiovascular morbidity is high in chronic haemodialysis patients. Previous studies showed a relation between uraemia-associated inflammation and cardiovascular mortality. This study intends to relate chronic inflammation to ultrasonographic markers of atherosclerotic cardiac or vascular alterations. METHODS: Complete echocardiographic status and sonography of the common carotid arteries with measurement of intima media thickness (IMT) was performed in 55 stable chronic haemodialysis patients and 15 patients with arterial hypertension and normal renal function (controls). C-reactive protein (CRP) was determined monthly. The number of cardiovascular events after initiation of haemodialysis treatment was recorded by analysis of the patient's files. RESULTS: Aortic valve sclerosis was found in 19 dialysis patients (34%) and 1 control (6%), haemodynamically relevant stenosis in additional 14 patients (25%) and 1 control. Carotid IMT thickening was frequent in both dialysis patients (38%) and controls (20%). Aortic stenosis was associated with chronically elevated CRP levels while aortic sclerosis and thickening of the carotid wall were not. Eleven patients had cardiovascular events in their history, tightly associated with chronically elevated CRP levels. CONCLUSIONS: Chronic inflammation in dialysis patients is associated with aortic valve stenosis and high prevalence of cardiovascular events but not with thickening of the carotid wall. This suggests pathogenetic differences between destructive vascular disease and arterial wall thickening.
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Schönenberger et al. (2004) conducted a cross-sectional in Chronic haemodialysis (n=70). Chronic haemodialysis vs. Arterial hypertension with normal renal function was evaluated on Aortic valve sclerosis. Chronic haemodialysis was associated with a higher prevalence of aortic valve sclerosis (34% vs 6%) and stenosis (25% vs 6.7%) compared to controls, with stenosis linked to chronically elevated CRP.
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