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Coronary artery calcification, common carotid artery intima-media thickness and aortic pulse wave velocity in patients on peritoneal dialysis.

Abstract

An increasing body of evidence suggests that atherosclerosis in patients with uremia differs from that found in general population in terms of advancement and localization of vascular lesions. It has also been suggested that different non-invasive techniques of vascular system evaluation are designed to show different types of lesions (i.e. vascular calcification, stiffness or 'classical' atherosclerosis). The aim of the study was to search for possible associations between results obtained with three different non-invasive methods of vascular system assessment in three different vascular sites in patients treated with peritoneal dialysis (PD). 61 patients (28 F, 33 M), mean age of 50.4+/-13.6 years, on maintenance PD for a median period of 10 months (range 1-96 months) were included. Coronary artery disease (CAD) was present in 21 subjects. In all subjects coronary artery calcification score (CaSc) using multi-row spiral computed tomography (MSCT), aortic pulse wave velocity (AoPWV) and ultrasound-based common carotid artery intima-media thickness (CCA-IMT) were performed as methods for assessing coronary calcium burden, arterial stiffness and atherosclerosis, respectively. Median value of CaSc equaled 11.5 Agatston units (range 0-5502.8 units). Median AoPWV was 10.4 m/s (range 7.56-18.1 m/s), and median CCA-IMT-0.6 mm (range 0.3-1.0 mm). In 16 patients (26.2%) at least one plaque in at least one common carotid artery was found on ultrasound. CaSc correlated with AoPWV (R=0.32, p<0.01) and with CCA-IMT (R=0.35, p<0.005), whereas no association was found between AoPWV and CCA-IMT. AoPWV, but not CaSc nor IMT correlated with blood pressure. The values of CCA-IMT and AoPWV increased together with consecutive Agatston categories (with p<0.001 for differences in AoPWV and p<0.05 for CCA-IMT). Patients with at least one plaque found in at least one CCA and patients with CAD were characterized with significantly higher values of CaSc, IMT and PWV, when compared to plaque-free and CAD- negative subjects, respectively. Association between CaSc and both IMT and PWV may suggest that the mechanism of three assessed vascular pathologies may be based, to some extent, on the process of pathologic calcium-phosphate deposition. Lack of correlation found between PWV and IMT may suggest that aortic stiffness and carotid atherosclerosis may partially differ in their pathologic background and/or are dissociated in time.

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  • Authors+Show Affiliations

    ,

    Department of Nephrology, Jagiellonian University, Cracow, Poland. stompin@mp.pl

    , , , , , , , , , , , ,

    Source

    MeSH

    Aorta
    Blood Flow Velocity
    Blood Pressure
    Calcinosis
    Carotid Artery Diseases
    Carotid Artery, Common
    Coronary Artery Disease
    Elasticity
    Female
    Humans
    Male
    Middle Aged
    Peritoneal Dialysis
    Pulsatile Flow
    Tomography, Spiral Computed
    Tunica Intima
    Tunica Media
    Ultrasonography

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16969750

    Citation

    Stompór, T, et al. "Coronary Artery Calcification, Common Carotid Artery Intima-media Thickness and Aortic Pulse Wave Velocity in Patients On Peritoneal Dialysis." The International Journal of Artificial Organs, vol. 29, no. 8, 2006, pp. 736-44.
    Stompór T, Rajzer M, Pasowicz M, et al. Coronary artery calcification, common carotid artery intima-media thickness and aortic pulse wave velocity in patients on peritoneal dialysis. Int J Artif Organs. 2006;29(8):736-44.
    Stompór, T., Rajzer, M., Pasowicz, M., Kraśniak, A., Sułowicz, W., Kawecka-Jaszcz, K., ... Janusz-Grzybowska, E. (2006). Coronary artery calcification, common carotid artery intima-media thickness and aortic pulse wave velocity in patients on peritoneal dialysis. The International Journal of Artificial Organs, 29(8), pp. 736-44.
    Stompór T, et al. Coronary Artery Calcification, Common Carotid Artery Intima-media Thickness and Aortic Pulse Wave Velocity in Patients On Peritoneal Dialysis. Int J Artif Organs. 2006;29(8):736-44. PubMed PMID: 16969750.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Coronary artery calcification, common carotid artery intima-media thickness and aortic pulse wave velocity in patients on peritoneal dialysis. AU - Stompór,T, AU - Rajzer,M, AU - Pasowicz,M, AU - Kraśniak,A, AU - Sułowicz,W, AU - Kawecka-Jaszcz,K, AU - Tracz,W, AU - Janda,K, AU - Tabor,B, AU - Kowalczyk-Michałek,M E, AU - Wójcik,K, AU - Konieczyńska,M, AU - Klimeczek,P, AU - Janusz-Grzybowska,E, PY - 2006/9/14/pubmed PY - 2007/1/11/medline PY - 2006/9/14/entrez SP - 736 EP - 44 JF - The International journal of artificial organs JO - Int J Artif Organs VL - 29 IS - 8 N2 - An increasing body of evidence suggests that atherosclerosis in patients with uremia differs from that found in general population in terms of advancement and localization of vascular lesions. It has also been suggested that different non-invasive techniques of vascular system evaluation are designed to show different types of lesions (i.e. vascular calcification, stiffness or 'classical' atherosclerosis). The aim of the study was to search for possible associations between results obtained with three different non-invasive methods of vascular system assessment in three different vascular sites in patients treated with peritoneal dialysis (PD). 61 patients (28 F, 33 M), mean age of 50.4+/-13.6 years, on maintenance PD for a median period of 10 months (range 1-96 months) were included. Coronary artery disease (CAD) was present in 21 subjects. In all subjects coronary artery calcification score (CaSc) using multi-row spiral computed tomography (MSCT), aortic pulse wave velocity (AoPWV) and ultrasound-based common carotid artery intima-media thickness (CCA-IMT) were performed as methods for assessing coronary calcium burden, arterial stiffness and atherosclerosis, respectively. Median value of CaSc equaled 11.5 Agatston units (range 0-5502.8 units). Median AoPWV was 10.4 m/s (range 7.56-18.1 m/s), and median CCA-IMT-0.6 mm (range 0.3-1.0 mm). In 16 patients (26.2%) at least one plaque in at least one common carotid artery was found on ultrasound. CaSc correlated with AoPWV (R=0.32, p<0.01) and with CCA-IMT (R=0.35, p<0.005), whereas no association was found between AoPWV and CCA-IMT. AoPWV, but not CaSc nor IMT correlated with blood pressure. The values of CCA-IMT and AoPWV increased together with consecutive Agatston categories (with p<0.001 for differences in AoPWV and p<0.05 for CCA-IMT). Patients with at least one plaque found in at least one CCA and patients with CAD were characterized with significantly higher values of CaSc, IMT and PWV, when compared to plaque-free and CAD- negative subjects, respectively. Association between CaSc and both IMT and PWV may suggest that the mechanism of three assessed vascular pathologies may be based, to some extent, on the process of pathologic calcium-phosphate deposition. Lack of correlation found between PWV and IMT may suggest that aortic stiffness and carotid atherosclerosis may partially differ in their pathologic background and/or are dissociated in time. SN - 0391-3988 UR - https://www.unboundmedicine.com/medline/citation/16969750/Coronary_artery_calcification_common_carotid_artery_intima_media_thickness_and_aortic_pulse_wave_velocity_in_patients_on_peritoneal_dialysis_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=16969750.ui DB - PRIME DP - Unbound Medicine ER -