Central pulse wave parameters are associated with valve calcification in patients with end-stage renal disease on maintenance hemodialysis

Abstract

BackgroundArterial stiffness is known marker of poor cardiovascular prognosis. The aim if the study was to assess the incidence of valve calcification (VC) in patients with end- stage renal disease (ESRD) and its associations with clinical parameters of arterial stiffness.MethodsIn 68 adults with ESRD on maintenance hemodialysis for >3 months (45.6% males, median age 58.3 (interquartile range (IQR) 54.6; 61.6) years, dialysis duration 62.7 (47.8; 77) months, echocardiography and applanation tonometry was performed.ResultsCalcification of the aortic, mitral and both valves was revealed in 46 (67.6%), 34 (50%) and 33 (48.5%) of patients. 20 (29%) patients had no signs of VC. Patients with vs without AVC were older (65.1 ± 9.5 vs 41.4 ± 11,9 years, p< 0.001), had higher dialysis duration (51 (8; 252) vs 21 (10; 38) months, p<0.01), lower peripheral diastolic blood pressure (DBP) (76 ± 17 vs 84 ± 12mmHg, p<0.05), central DBP (75 ± 15 vs 82 ± 11 mmHg, p<0.05), reflected wave transit time (RWTT) (131 ± 17 vs 137 ± 15 ms, p<0.05). Patients with vs without MVC were older (67.8 ± 8.2 vs 47.9 ± 13,5 years, p < 0.001), had higher dialysis duration (51 (34; 111) vs 36 (14; 57) months, p<0.01), carotid-femoral pulse wave velocity (10.1 ± 2.7 vs 8.9 ± 3.5 m/s, p<0.05), lower peripheral DBP (73 ± 17vs 84 ± 14 mmHg, p< 0.01), central DBP (72 ± 13 vs 83 ± 13 mmHg, p< 0.001), higher central pulse pressure (52 ± 13 vs 45 ± 16mmHg, p<0.05), lower RWTT (133 (120; 130) vs 135 (132; 142) ms, p < 0.05).ConclusionHigh prevalence of VC (71%) was revealed in patients with ESRD on maintenance hemodialysis. Patients with vs without VC were older, had higher duration of dialysis and more pronounced arterial stiffness.