Cardiac valve calcification by echocardiography predicts coronary artery calcium scores in dialysis patients

Abstract

Objective To determine whether cardiac valve calcification on echocardiography could predict coronary artery calcium scores (CACS) in hemodialysis patients. Methods This was a cross-sectional study of 169 stage V hemodialysis patients. The presence of calcification of the cardiac valves was assessed by echocardiography. All patients underwent multi-slice spiral computed tomography for quantification of CACS. According to CACS, they were divided into 3 groups (11-100, 101-400, and≥400). According to cardiac valve calcification, they were divided into 4 groups: no valve calcification, aortic valve calcification, mitral valve calcification and aotic/mitral valve calcification. Logistic regression was used to calculate the odds ratios (ORs) of having a CACS greater than 10, 100 and 400 in presence of valve calcification. Results Eighty-eight patients (52.07%) had echocardiographic evidence of valvular calcification. Patients with aortic valve calcification, mitral valve calcification and aotic/mitral valve calcification had a significantly greater likelihood of having CACS≥400 [OR=4.61, 95% confidence interval (95%CI) 1.22-17.4, P=0.02; OR = 5.31, 95%CI 1.37-20.5, P=0.01; OR = 16.94, 95%CI 5.16-55.58, P=0.001]. Conclusions The cardiac valve calcification in hemodialysis patients was strongly associated with the presence and degree of CACS independently of clinical risk factors. Echocardiography is a useful method to predict CACS in hemodialysis patients by detecting cardiac valve calcification. Key words: Renal dialysis; Heart valves; Echocardiography, stress