Heart Valve Calcifications, Survival, and Cardiovascular Risk in Hemodialysis Patients

Vincenzo Panuccio, Rocco Tripepi, Giovanni Tripepi, Francesca Mallamaci, Francesco A. Benedetto, Alessandro Cataliotti, Ignazio Bellanuova, Giuseppe Giacone, Lorenzo S. Malatino, Carmine Zoccali

Research output: Contribution to journalArticlepeer-review

43 Scopus citations

Abstract

Background: Cardiovascular (CV) calcifications constitute a strong risk marker, and recent studies in continuous ambulatory peritoneal dialysis patients have associated valvular calcifications to inflammation, mortality, and CV events. The prognostic value of cardiac valve calcifications and their relationship with left ventricular hypertrophy and background cardiovascular risk in hemodialysis patients is still unknown. Methods: The prognostic value of heart valve calcifications (detected by echocardiography) for all-cause and CV death was tested in a cohort of 202 hemodialysis (HD) patients. Results: Forty-seven patients had 1 or more calcified valves. Background CV complications were more frequent (P = 0.001) and left ventricular hypertrophy was more severe (P < 0.001) in patients with calcified valves than in those without this alteration. During the follow-up period (44 ± 23 months), 96 patients died, 66 patients (69%) of CV causes. Valve calcifications were significantly associated with all-cause (P = 0.02) and CV mortality (P ≤ 0.001). However, in statistical models adjusting for traditional and nontraditional CV risk factors and background CV complications and left ventricular mass index (LVMI), the relationship between calcified valves and incident all-cause and CV mortality was not significant. Conclusion: In HD patients, cardiac valve calcifications predict all-cause and CV mortality in unadjusted analyses, but these associations are not evident in models adjusting for background CV complications, LVMI, and other risk factors. Cardiac valve calcifications do not provide an independent contribution in the prediction of death and CV mortality.

Original languageEnglish (US)
Pages (from-to)479-484
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume43
Issue number3
DOIs
StatePublished - Mar 2004

Keywords

  • Cardiovascular (CV) risk
  • Chronic renal failure (CRF)
  • Hemodialysis (HD)
  • Left ventricular hypertrophy
  • Uremia
  • Valve calcifications

ASJC Scopus subject areas

  • Nephrology

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