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Cardiac valve calcification is associated with presence and severity of coronary artery disease in patients with pre-dialysis chronic kidney disease

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Abstract

Background

Cardiac valve calcification is common in chronic kidney disease (CKD) patients. Coronary artery disease (CAD) is the one of major causes for increased cardiovascular mortality in CKD patients. We hypothesized that cardiac valve calcification is associated with the presence and the severity of CAD in pre-dialysis CKD patients.

Methods

This study included 1166 patients who underwent transthoracic echocardiography for assessment of cardiac valve calcification and coronary angiography for assessment of CAD. The patients were divided into two groups according to estimated glomerular filtration rate (eGFR): pre-dialysis CKD group (n = 215, eGFR < 60 ml/min/1.73 m2) and non-CKD group (n = 951, eGFR ≥ 60 ml/min/1.73 m2).

Results

In the pre-dialysis CKD group, subjects with aortic valve calcification (AVC), mitral valve calcification (MVC), and at least one valve calcification had more severe CAD compared with those without AVC, MVC, and any valve calcification. Multivariate analysis showed that pre-dialysis CKD patients who had AVC, MVC, and at least one valve calcification were 3.02 times (P = 0.033), 3.73 times (P = 0.029), and 3.31 times (P = 0.012) more likely to have CAD compared with those without AVC, MVC, and any valve calcification, respectively. However, in the non-CKD group, there was no association between cardiac valve calcification and the severity/presence of CAD.

Conclusions

Cardiac valve calcification is associated with the presence and severity of CAD in pre-dialysis CKD. Assessment of cardiac valve calcification by means of transthoracic echocardiography could be a valuable non-invasive method for CAD risk stratification in pre-dialysis CKD patients.

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References

  1. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305.

    Article  CAS  PubMed  Google Scholar 

  2. Muntner P, He J, Hamm L, Loria C, Whelton PK. Renal insufficiency and subsequent death resulting from cardiovascular disease in the united states. J Am Soc Nephrol. 2002;13:745–53.

    PubMed  Google Scholar 

  3. Culleton BF, Larson MG, Wilson PW, Evans JC, Parfrey PS, Levy D. Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. Kidney Int. 1999;56:2214–9.

    Article  CAS  PubMed  Google Scholar 

  4. Henry RM, Kostense PJ, Bos G, Dekker JM, Nijpels G, Heine RJ, et al. Mild renal insufficiency is associated with increased cardiovascular mortality: the Hoorn study. Kidney Int. 2002;62:1402–7.

    Article  PubMed  Google Scholar 

  5. Maher ER, Young G, Smyth-Walsh B, Pugh S, Curtis JR. Aortic and mitral valve calcification in patients with end-stage renal disease. Lancet. 1987;2:875–7.

    Article  CAS  PubMed  Google Scholar 

  6. Ritschard T, Blumberg A, Jenzer HR. Mitral annular calcification in dialysis patients. Schweiz Med Wochenschr. 1987;117:1363–7.

    CAS  PubMed  Google Scholar 

  7. Raos V, Jeren-Strujić B, Antos M, Horvatin-Godler S. Frequency of mitral annular calcification in patients on hemodialysis estimated by 2-dimensional echocardiography. Acta Med Croat. 1996;50:179–83.

    CAS  Google Scholar 

  8. Varma R, Aronow WS, McClung JA, Garrick R, Vistainer PF, Weiss MB, et al. Prevalence of valve calcium and association of valve calcium with coronary artery disease, atherosclerotic vascular disease, and all-cause mortality in 137 patients undergoing hemodialysis for chronic renal failure. Am J Cardiol. 2005;95:742–3.

    Article  CAS  PubMed  Google Scholar 

  9. Raggi P, Boulay A, Chasan-Taber S, Amin N, Dillon M, Burke SK, et al. Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease and cardiovascular disease? J Am Coll Cardiol. 2002;39:695–701.

    Article  PubMed  Google Scholar 

  10. Wang AY, Wang M, Woo J, Lam CW, Li PK, Lui SF, et al. Cardiac valve calcification as an important predictor for all-cause mortality and cardiovascular mortality in long-term peritoneal dialysis patients: a prospective study. J Am Soc Nephrol. 2003;14:159–68.

    Article  PubMed  Google Scholar 

  11. Sharma R, Pellerin D, Gaze DC, Mehta RL, Gregson H, Streather CP, et al. Mitral annular calcification predicts mortality and coronary artery disease in end stage renal disease. Atherosclerosis. 2007;191:348–54.

    Article  CAS  PubMed  Google Scholar 

  12. Raggi P, Bellasi A, Gamboa C, Ferramosca E, Ratti C, Block GA, et al. All-cause mortality in hemodialysis patients with heart valve calcification. Clin J Am Soc Nephrol. 2011;6:1990–5.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol. 1983;51:606.

    Article  CAS  PubMed  Google Scholar 

  14. Fox CS, Larson MG, Vasan RS, Guo CY, Parise H, Levy D, et al. Cross-sectional association of kidney function with valvular and annular calcification: the Framingham heart study. J Am Soc Nephrol. 2006;17:521–7.

    Article  PubMed  Google Scholar 

  15. Ix JH, Shlipak MG, Katz R, Budoff MJ, Shavelle DM, Probstfield JL, et al. Kidney function and aortic valve and mitral annular calcification in the multi-ethnic study of atherosclerosis (mesa). Am J Kidney Dis. 2007;50:412–20.

    Article  CAS  PubMed  Google Scholar 

  16. Asselbergs FW, Mozaffarian D, Katz R, Kestenbaum B, Fried LF, Gottdiener JS, et al. Association of renal function with cardiac calcifications in older adults: the cardiovascular health study. Nephrol Dial Transpl. 2009;24:834–40.

    Article  Google Scholar 

  17. Leskinen Y, Paana T, Saha H, Groundstroem K, Lehtimäki T, Kilpinen S, et al. Valvular calcification and its relationship to atherosclerosis in chronic kidney disease. J Heart Valve Dis. 2009;18:429–38.

    PubMed  Google Scholar 

  18. Roberts WC. The senile cardiac calcification syndrome. Am J Cardiol. 1986;58:572–4.

    Article  CAS  PubMed  Google Scholar 

  19. Thubrikar MJ, Deck JD, Aouad J, Chen JM. Intramural stress as a causative factor in atherosclerotic lesions of the aortic valve. Atherosclerosis. 1985;55:299–311.

    Article  CAS  PubMed  Google Scholar 

  20. Boon A, Cheriex E, Lodder J, Kessels F. Cardiac valve calcification: characteristics of patients with calcification of the mitral annulus or aortic valve. Heart. 1997;78:472–4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Nair CK, Sudhakaran C, Aronow WS, Thomson W, Woodruff MP, Sketch MH. Clinical characteristics of patients younger than 60 years with mitral anular calcium: comparison with age- and sex-matched control subjects. Am J Cardiol. 1984;54:1286–7.

    Article  CAS  PubMed  Google Scholar 

  22. Fox CS, Vasan RS, Parise H, Levy D, O’Donnell CJ, D’Agostino RB, et al. Mitral annular calcification predicts cardiovascular morbidity and mortality: the Framingham heart study. Circulation. 2003;107:1492–6.

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Gyeongsangnam-do, South Korea

    Il Young Kim, Min Jung Kim, Dong Won Lee, Soo Bong Lee, Min Ji Shin, Harin Rhee, Byeong Yun Yang, Sang Heon Song, Eun Young Seong & Ihm Soo Kwak

  2. Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea

    Il Young Kim, Min Jung Kim, Dong Won Lee & Soo Bong Lee

  3. Medical Research Institute, Pusan National University Hospital, Busan, South Korea

    Min Ji Shin, Harin Rhee, Byeong Yun Yang, Sang Heon Song, Eun Young Seong & Ihm Soo Kwak

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  1. Il Young Kim
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  2. Min Jung Kim
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  3. Dong Won Lee
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Correspondence to Soo Bong Lee.

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Kim, I.Y., Kim, M.J., Lee, D.W. et al. Cardiac valve calcification is associated with presence and severity of coronary artery disease in patients with pre-dialysis chronic kidney disease. Clin Exp Nephrol 19, 1090–1097 (2015). https://doi.org/10.1007/s10157-015-1104-4

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  • DOI: https://doi.org/10.1007/s10157-015-1104-4

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