Abstract
The cardiothoracic ratio (CTR) and peripheral arterial occlusive disease (PAOD) are related to mortality in hemodialysis patients. However, data on the association between PAOD and CTR are limited. In this study, we aim to elucidate this relationship in patients on chronic hemodialysis. Using a retrospective cross-sectional study of 622 Taiwanese patients, we investigated the association of PAOD and CTR. PAOD was significantly associated with CTR in the crude analysis. The odds ratio (OR) for CTR >0.5 was 1.77 [95% confidence interval (CI), 1.32–2.37], and the odds ratio for CTR >0.6 was 2.18 [95% CI, 1.44–3.30]. After adjusting for confounding variables, this difference continued to exhibit significant predictive power for CTR >0.6 (OR, 1.88; 95% CI, 1.14–3.11), but the predictive power for CTR >0.5 was attenuated (OR, 1.41; 95% CI, 0.98–2.03). In the subgroup analysis, PAOD was an independent factor for CTR >0.6, particularly in elderly and female patients or patients with hemoglobin >10 mg/dl and with no history of cardiovascular disease. In this research, we showed that the detection of PAOD was independently associated with CTR >0.6 in patients on chronic hemodialysis.
Highlights
The cardiothoracic ratio (CTR) and peripheral arterial occlusive disease (PAOD) are related to mortality in hemodialysis patients
The cardiothoracic ratio (CTR) represents the left ventricular size and is estimated from chest X-rays as a proportion of the thoracic diameter[1]; CTR is negatively associated with cardiac systolic dysfunction[2]
The ankle–brachial index (ABI), which is a ratio of ankle to brachial systolic blood pressure (BP), is a simple, non-invasive and reliable tool to diagnose peripheral arterial occlusive disease (PAOD)[8], an atherosclerotic disorder that refers to varying degrees of occlusion of the lower limb arteries and is frequently observed in CKD9,10 and chronic hemodialysis (CHD) patients[11,12]
Summary
The cardiothoracic ratio (CTR) and peripheral arterial occlusive disease (PAOD) are related to mortality in hemodialysis patients. PAOD was an independent factor for CTR >0.6, in elderly and female patients or patients with hemoglobin >10 mg/dl and with no history of cardiovascular disease. The ankle–brachial index (ABI), which is a ratio of ankle to brachial systolic blood pressure (BP), is a simple, non-invasive and reliable tool to diagnose peripheral arterial occlusive disease (PAOD)[8], an atherosclerotic disorder that refers to varying degrees of occlusion of the lower limb arteries and is frequently observed in CKD9,10 and chronic hemodialysis (CHD) patients[11,12]. A lower (1.4) ABI value in CKD patients induces a higher event rate of acute myocardial infarction or cardiovascular disease (CVD)[17] Both cardiomegaly and PAOD contribute to CVD development in CHD patients. This study investigates the association between PAOD and CTR in patients with CHD
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