Prognosis of Heart Valve Calcification on Cardiovascular Events in Hemodialysis Patients without Central Venous Catheters

Cardiorenal medicine

article

Huang, Xiao-mei¹  Du, Min²  Zhang, Yi³  Gu, Lian-qing¹  Fu, Hui-ling¹  Yu, Fen³  Xu, Li³  Li, Jing-jing³  Wang, Yin¹  Sun, Xiao-feng³ 

[1] Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology;Department of Public Health, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology;Department of Ultrasound, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology

关键词: All-cause mortality;    Aortic valve calcification;    Cardiovascular events;    Heart valvular calcification;    Hemodialysis;    Mitral valve calcification;   

DOI  :  10.1159/000529136

学科分类：心脏病和心血管学

来源: S Karger AG

【 摘 要 】

Introduction: Heart valvular calcification (HVC) is an important predictor of cardiovascular events (CEs) and all-cause mortality in dialysis patients. Patients in the early stage of dialysis or those with central venous catheters (CVC) are also at high risk of cardiovascular and all-cause mortality. It could be a confounding factor for the prognosis of HVC on CE. Methods: From March 2017 to April 2022, the prognosis of HVC on CE and all-cause mortality was studied retrospectively in 158 hemodialysis (HD) patients who used arteriovenous fistulas or arteriovenous grafts as vascular access and entered HD for more than 12 months. Results: Out of 158 patients, 70 (44.3%) were diagnosed with HVC via echocardiography. A total of 180 CEs occurred during follow-up. Among them, acute heart failure accounted for 62.66%, and its prevalence was significantly higher in the HVC group than that in the non-HVC group (p < 0.0001). The cumulative incidence of CE-free survival in the HVC group was significantly lower than that in the non-HVC group (p = 0.030). Only 11 patients died, and there was no significant difference in all-cause mortality between the two groups (p = 0.560). Multivariate COX regression analyses showed that HD vintage, mitral valve calcification, and aortic valve regurgitation (AR)/aortic valve stenosis (AS) but not aortic valve calcification were risk factors for CE (p < 0.05). Conclusion: After excluding the factors of the early stage of HD and CVC, HVC remained a predictor of adverse CE in HD patients.

【 授权许可】

CC BY