Artery Research

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Volume 4, Issue 3, September 2010, Pages 81 - 90

Role of aortic calcification, stiffness and wave reflections in cardiovascular risk in dialysis patients: Baseline data from the CORD study

Authors
Francis Verbekea, *, Raymond Vanholdera, Pieter L. Rensmab, Björn Wikströmc, Per Bruno Jensend, Jean-Marie Krzesinskie, Merete Rasmussenf, Wim Van Biesena, Eero Honkaneng, on behalf of the CORD Study investigatorsh
aDepartment of Internal Medicine, Nephrology Section, Gent University Hospital, Gent, Belgium
bDepartment of Nephrology, St. Elisabeth Hospital Tilburg, Tilburg, The Netherlands
cRenal Section, Department of Medicine, Uppsala University Hospital, Uppsala, Sweden
dDepartment of Nephrology, Odense University Hospital, Odense, Denmark
eDepartment of Nephrology, Liege University Hospital, Liege, Belgium
fGenzyme A/S, Copenhagen, Denmark
gDivision of Nephrology Helsinki University Central Hospital, Helsinki, Finland
h

See appendix section.

*Corresponding author at: Gent University Hospital, Department of Internal Medicine, Nephrology section, De Pintelaan 185, B-9000 Gent, Belgium. Tel.: +32 9 332 45 12; fax: +32 9 332 38 47. E-mail address: francis.verbeke@ugent.be (F. Verbeke).
Corresponding Author
Francis Verbeke
Received 23 April 2010, Revised 9 June 2010, Accepted 17 June 2010, Available Online 14 July 2010.
DOI
10.1016/j.artres.2010.06.004How to use a DOI?
Keywords
Calcification; Pulse wave velocity; Stiffness; Augmentation index; Dialysis
Abstract

Background: Accurate cardiovascular risk estimation in dialysis patients remains challenging because different pathogenetic mechanisms act simultaneously in this heterogeneous population. Radiographic calcification, aortic stiffness and wave reflection, have each individually been proven to be reliable surrogate markers for outcome. We aimed to explore to what extent these parameters intermutually provide complementary or overlapping information.

Methods: Abdominal aortic calcification scoring of a plain lateral abdominal X-ray, carotid-femoral pulse wave velocity (PWV), and central augmentation index (AIx) were measured in 1084 dialysis patients, recruited from 47 European dialysis centers.

Results: Abdominal calcification correlated well with PWV (R = 0.44, P < 0.001) but poorly with AIx (R = 0.07, P = 0.04). Next to abdominal calcification, tertiles of PWV were associated with a stepwise increase age, blood pressure, and cardiovascular history, and tertiles of AIx with age, heart rate, and anthropometric factors. In multivariate analysis, only PWV remained significantly associated with calcification score. In addition to age and blood pressure, stiffness was mainly related to diabetes and calcification score (R2 = 0.39, P < 0.001), whereas AIx was more dependent on anthropometry, gender and heart rate (R2 = 0.36, P < 0.001).

Conclusions: Information on aortic calcification and arterial abnormalities can be obtained by simple and inexpensive methodologies. Variation in wave reflections was mainly explained by anthropometric parameters. Stiffness and calcification partly provided complementary information, particularly in low-risk patients. In this group, likely to benefit most from preventive strategies and commonly considered for renal transplantation, evaluation of cardiovascular risk could be made more accurate by the assessment of both aortic calcification and arterial stiffness.

Copyright
© 2010 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

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<Previous Article In Issue
Next Article In Issue>
Journal
Artery Research
Volume-Issue
4 - 3
Pages
81 - 90
Publication Date
2010/07/14
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2010.06.004How to use a DOI?
Copyright
© 2010 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Francis Verbeke
AU  - Raymond Vanholder
AU  - Pieter L. Rensma
AU  - Björn Wikström
AU  - Per Bruno Jensen
AU  - Jean-Marie Krzesinski
AU  - Merete Rasmussen
AU  - Wim Van Biesen
AU  - Eero Honkanen
AU  - on behalf of the CORD Study investigators
PY  - 2010
DA  - 2010/07/14
TI  - Role of aortic calcification, stiffness and wave reflections in cardiovascular risk in dialysis patients: Baseline data from the CORD study
JO  - Artery Research
SP  - 81
EP  - 90
VL  - 4
IS  - 3
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2010.06.004
DO  - 10.1016/j.artres.2010.06.004
ID  - Verbeke2010
ER  -