B-flow imaging estimation of carotid and femoral atherosclerotic plaques: vessel walls rheological damage or strong predictor of cardiovascular mortality in chronic dialysis patients.

Abstract

The aim of this study was to investigate the cardiovascular mortality in chronic hemodialysis patients (CHPs) and to discover the importance of carotid and femoral artery plaques as cardiovascular (CV) mortality predictor. In this study with 4years of follow-up period, we studied a cohort of 101 CHPs. Mean age at entry was 58.1±11.9years, and mean duration of dialysis was 5.8±5.3years. We performed B-flow imaging of both carotid and femoral arteries to estimate and score the plaque thickness. The mean carotid and femoral plaque scores (PSs) at entry were 5.02±4.20 and 4.04±3.30 (p=0.0002). The carotid cutoff point and femoral cutoff point (by ROC curves) were 5.4 and 5.9. The regression coefficients (b) and Exp (b) hazard ratio coefficients of carotid and femoral PS in Cox regression survival analysis in CV outcomes were: b=0.142, Exp (b)=1.153, p=0.0035 versus b=0.457, Exp (b)=1.578, p<0.0001. Relative hazard ratio (HR) risk of exposed group according to CV events was HR 2.812 (CI 1.301-6.081) for carotid PS and HR 2926 (CI 1.424-6.013) for femoral PS. Carotid and femoral plaques are strong independent predictors of CV mortality in CHPs. The HR risk of femoral artery plaques is more predictable than HR risk of carotid artery plaques.