Does Vascular Calcification Correlate with Pulse Wave Velocity in Hemodialysis Patients?

Abstract

<p style="margin: 0.0px 0.0px 0.0px 0.0px; font: 10.0px Verdana;">Vascular calcifications have been previously shown to be an independent predictor of mortality in dialysis patients and a similar association has been shown for arterial stiffness. Nonetheless, the relationship between vascular calcifications and pulse wave velocity (PWV) have so far been little explored. The goal of this study is to verify the correlation among vascular calcifications and rigidity of arterial wall in patients at dialysis start. Accordingly, we investigated the association between aortic PWV and coronary calcification measured by computed tomography (TC-score) in 105 adult incident hemodialysis patients. PWV resulted increased in patients with the higher TC-score values; indeed, at univariate analysis PWV directly correlated with age (p=0.016), presence of diabetes (p lower than 0.0001), serum phosphorus (p=0.0066), C-reactive protein (CRP) (p=0.046), LDL-cholesterol (p=0.043), TC-score (p lower than 0.0001), and inversely correlated with systolic blood pressure (p=0.036). At multivariate analysis, age, diabetes, serum phosphorus, CRP, LDL-cholesterol and vascular calcifications were determinants of arterial stiffening. Using the table “two for two”, we showed 6 false negative patients (high TC-score and low PWV) and 12 false positive patients (low TC-score and high PWV). The sensibility was 76% and the specificity 85%; the accuracy was 83%, the predictor positive value was 61% and the predictor negative value was 92%. Overall, a strong association between TC-score and PWV was seen.</p

Radiographic Assessment of Vascular Calcification, Aortic Pulse Wave Velocity, Ankle‐Brachial Index and Fibroblast Growth Factor‐23 in Chronic Hemodialysis Patients

“…Vascular calcification induces arterial stiffness and increases aPWV in elastic type arteries . We have found a significant correlation of aPWV with CACS.…”

“…. Arterial remodeling is related to intrinsic characteristics of the vascular wall . Vascular calcification affects vascular stiffness and raises the pulse wave velocity (PWV) of elastic‐type arteries.…”

Variability of pulse wave velocity and mortality in chronic hemodialysis patients

“…Indeed, our data, in which the use of ACE inhibitors is similarly distributed in 3 groups, demonstrate that the behavior of PWV during dialysis depends on vascular calcification values: higher vascular calcification leads to higher PWV, and these high PWV values also remain high after dialysis treatment 12 …”

“…They performed 3 HD sessions of 4 hours per week. Patients were required to have a steady achieved dry weight in the previous 3 months (assessed by either inferior vena cava diameter or bioelectrical impedance analysis) to be enrolled into the study 11,12 . Exclusion criteria were acute CV accidents and infections in the previous 3 months, advanced heart failure (New York Heart Association III to IV stages) or atrial fibrillation or arrhythmias, liver disease or ascites, acute or neoplastic illness and overt edema.…”

“…Electron beam CT was performed according to a standard protocol as described previously 12 . In order to quantify presence and extent of arterial calcification, each patient underwent a multislice spiral CT scan.…”