Document Detail

Heart valve calcifications, survival, and cardiovascular risk in hemodialysis patients.
MedLine Citation:
PMID:  14981606     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cardiovascular (CV) calcifications constitute a strong risk marker, and recent studies in continuous ambulatory peritoneal dialysis patients have associated valvular calcifications to inflammation, mortality, and CV events. The prognostic value of cardiac valve calcifications and their relationship with left ventricular hypertrophy and background cardiovascular risk in hemodialysis patients is still unknown. METHODS: The prognostic value of heart valve calcifications (detected by echocardiography) for all-cause and CV death was tested in a cohort of 202 hemodialysis (HD) patients. RESULTS: Forty-seven patients had 1 or more calcified valves. Background CV complications were more frequent (P = 0.001) and left ventricular hypertrophy was more severe (P < 0.001) in patients with calcified valves than in those without this alteration. During the follow-up period (44 +/- 23 months), 96 patients died, 66 patients (69%) of CV causes. Valve calcifications were significantly associated with all-cause (P = 0.02) and CV mortality (P < or = 0.001). However, in statistical models adjusting for traditional and nontraditional CV risk factors and background CV complications and left ventricular mass index (LVMI), the relationship between calcified valves and incident all-cause and CV mortality was not significant. CONCLUSION: In HD patients, cardiac valve calcifications predict all-cause and CV mortality in unadjusted analyses, but these associations are not evident in models adjusting for background CV complications, LVMI, and other risk factors. Cardiac valve calcifications do not provide an independent contribution in the prediction of death and CV mortality.
Vincenzo Panuccio; Rocco Tripepi; Giovanni Tripepi; Francesca Mallamaci; Francesco A Benedetto; Alessandro Cataliotti; Ignazio Bellanuova; Giuseppe Giacone; Lorenzo S Malatino; Carmine Zoccali
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  43     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-02-24     Completed Date:  2004-05-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  479-84     Citation Subset:  IM    
National Research Council, Institute of Biomedicine, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy.
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MeSH Terms
Calcinosis / complications*,  ultrasonography
Cardiovascular Diseases / mortality*
Cause of Death
Heart Valve Diseases / complications*,  ultrasonography
Hypertrophy, Left Ventricular / complications,  ultrasonography
Kidney Failure, Chronic / complications*,  therapy
Middle Aged
Proportional Hazards Models
Renal Dialysis*
Risk Factors

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