High brachial-ankle pulse wave velocity (OR 1.065; 95% CI 1.003-1.129; P=0.038) and cardiothoracic ratio were independently associated with severe aortic arch calcification in hemodialysis patients.
Observational (n=220)
Are brachial-ankle pulse wave velocity and cardiomegaly associated with severe aortic arch calcification in hemodialysis patients?
In hemodialysis patients, severe aortic arch calcification on plain chest radiography is independently associated with increased arterial stiffness (baPWV) and cardiomegaly.
Effect estimate: OR 1.065 (95% CI 1.003-1.129)
p-value: p=0.038
Aortic arch calcification (AoAC) is associated with cardiovascular and all-cause mortality in end-stage renal disease population. AoAC can be simply estimated with an AoAC score using plain chest radiography. The objective of this study is to evaluate the association of AoAC with brachial-ankle pulse wave velocity (baPWV) and cardiomegaly in patients who have undergoing hemodialysis (HD).We retrospectively determined AoAC and cardiothoracic ratio (CTR) by chest x-ray in 220 HD patients who underwent the measurement of baPWV. The values of baPWV were measured by an ankle-brachial index-form device. Multiple stepwise logistic regression analysis was used to identify the factors associated with AoAC score >4.Compared patients with AoAC score ≦4, patients with AoAC score >4 had older age, higher prevalence of diabetes and cerebrovascular disease, lower diastolic blood pressure, higher baPWV, higher CTR, higher prevalence of CTR ≧50%, lower total cholesterol, and lower creatinine level. After the multivariate stepwise logistic analysis, old age, cerebrovascular disease, high baPWV (per 100 cm/s, odds ratio OR 1.065, 95% confidence interval CI 1.003-1.129, P = 0.038), CTR (per 1%, OR 1.116, 95% CI 1.046-1.191, P = 0.001), and low total cholesterol level were independently associated with AoAC score >4.Our study demonstrated AoAC severity was associated with high baPWV and high CTR in patients with HD. Therefore, we suggest that evaluating AoAC on plain chest radiography may be a simple and inexpensive method for detecting arterial stiffness in HD patients.
Shih et al. (2016) conducted an observational in Hemodialysis (n=220). Brachial-ankle pulse wave velocity (baPWV) and cardiothoracic ratio (CTR) was evaluated on Aortic arch calcification (AoAC) score >4 (OR 1.065, 95% CI 1.003-1.129, p=0.038). High brachial-ankle pulse wave velocity (OR 1.065; 95% CI 1.003-1.129; P=0.038) and cardiothoracic ratio were independently associated with severe aortic arch calcification in hemodialysis patients.