LB.02.18] DIFFERENCE BETWEEN CAROTID-FEMORAL AND CAROTID-RADIAL PULSE WAVE VELOCITY CAN INDICATE THE EXTENT OF AORTIC ARCH CALCIFICATION IN DIALYSIS PATIENTS

Abstract

Objective: Aortic arch calcification (AoAC) score evaluated on plain chest X-ray was proven to be associated with increased cardiovascular risk. We aimed to determine whether the difference between carotid-femoral pulse wave velocity (CFPWV) and carotid-radial pulse wave velocity (CRPWV) could describe the extent of AoAC in dialysis patients. Design and method: This cross-sectional study included 61 dialysis patients without previous vascular events. They all underwent chest X-ray. Two radiologists blinded to patient medical records graded aortic arch calcification (AoAC) by using a scale from 0 to 3 (grade0–no visible calcification, grade1 - < 50% calcification in the arch, grade2 - >50% calcification, grade3–circumferential calcification). These patients had their CFPWV and CRPW measured and the difference (δPWV=CFPWV-CRPWV) calculated. Biochemical blood tests included creatinine, urea, uric acid, cystatin C, ferritin, protein, albumin, C-reactive protein (CRP), calcium, phosphate, parathormone, total cholesterol, haemoglobin, platelets, white blood cells. Corrected total calcium and calcium phosphate products were calculated. According to AoAC grade patients were divided into 3 groups: group A–AoAC grade0, group B–grade1, group C–grade2, 3. Results: Patients with AoAC were significantly older, shorter in height, had higher than 25 kg/m2 body mass index (BMI), lower peripheral and central diastolic BP, lower end systolic BP, higher CRP levels. Group B had significantly lower phosphate and calcium phosphate product levels. We observed that patients with AoAC had higher CFPWV, but lower CRPWV values. δPWV was as follows: A -0,05, B 1,72, C 4,23, p = 0,115. On multivariate logistic regression models group A was significantly associated with δPWV (OR 0.48), albumin level (OR 0.69), diastolic BP (OR 1.13), BMI (OR 0.68) and time on dialysis (OR 0.99); group C–with δPWV (OR 1.73) and phosphate (OR 1.25). In group B the association was only with CRPWV (OR 0.50), BMI (OR 1.17), δPWV had no significant influence. Conclusions: The discrepancy between CFPWV and CRPWV measurement confirms different pattern of elastic vessels (Aorta) and muscular conduit arteries (radial arteries) and can describe the extent of aortic arch calcification in dialysis patients.