Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013;10(5):617-23.
doi: 10.7150/ijms.5773. Epub 2013 Mar 21.

The prognostic value of abdominal aortic calcification in peritoneal dialysis patients

Hye Eun Yoon  1 , Bo Geun Park, Hyeon Seok Hwang, Sungjin Chung, Cheol Whee Park, Chul Woo Yang, Yong-Soo Kim, Seok Joon Shin
Affiliations

The prognostic value of abdominal aortic calcification in peritoneal dialysis patients

Hye Eun Yoon et al. Int J Med Sci. 2013.

Abstract

Objective: This study evaluated the prognostic value of the 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 peritoneal dialysis (PD) patients.

Method: PD patients who received both abdominal CT and echocardiography were divided into a low-ACI group (n=46) and a high-ACI group (n=46).

Results: During follow-up (median, 35.2 months; range, 3.6-111.3), 30 patients (32.6%) died and 10 patients (10.9%) developed nonfatal cardiovascular (CV) events. The 5-year 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 (35.7% vs. 64.1%, P = 0.01). The ACI was positively correlated with left atrial diameter and ratio of peak early transmitral flow velocity to peak early diastolic mitral annular velocity (E/E' ratio; a marker of left ventricular diastolic function). Using multivariate analyses, the high-ACI group (vs. low-ACI group, HR 5.25, 95% CI 1.77-15.58, P = 0.003) and increased E/E' ratio (HR 1.16, 95% CI 1.03-1.31, P = 0.013) were independent predictors for mortality and CV events. The ACI provided a higher predictive value for adverse outcomes (AUC = 0.755, P = 0.002) than the E/E' ratio (AUC = 0.543, P = 0.61).

Conclusion: The ACI was significantly associated with left ventricular diastolic dysfunction and predicted all-cause mortality and nonfatal CV events in PD patients.

Keywords: Aortic calcification; cardiovascular disease; left ventricular diastolic dysfunction; mortality; peritoneal dialysis..

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Comparison of event-free survival rates for all-cause mortality and nonfatal cardiovascular (CV) events between the low-aortic calcification index (ACI) group and the high-ACI group. Note that the event-free survival rates for the high-ACI group were significantly lower than the low-ACI group at 5 years (P = 0.01).
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve for all-cause mortality and nonfatal cardiovascular events with calculated area under the ROC curve (AUC). The ACI provided a higher predictive value for adverse outcomes than the E/E' ratio. ACI: aortic calcification index; E/E' ratio: a ratio of peak early transmitral flow velocity (E) to peak early diastolic mitral annular velocity (E').
See this image and copyright information in PMC

References

    1. Foley RN, Murray AM, Li S. et al. Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States Medicare population, 1998 to 1999. J Am Soc Nephrol. 2005;16:489–95. - PubMed
    1. London GM, Guerin AP, Marchais SJ. et al. Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant. 2003;18:1731–40. - PubMed
    1. Raggi P, Bellasi A. Clinical assessment of vascular calcification. Adv Chronic Kidney Dis. 2007;14:37–43. - PubMed
    1. Witteman JC, Kok FJ, van Saase JL. et al. Aortic calcification as a predictor of cardiovascular mortality. Lancet. 1986;2:1120–2. - PubMed
    1. Sigrist MK, Taal MW, Bungay P. et al. Progressive vascular calcification over 2 years is associated with arterial stiffening and increased mortality in patients with stages 4 and 5 chronic kidney disease. Clin J Am Soc Nephrol. 2007;2:1241–8. - PubMed

Publication types

LinkOut - more resources