Aortic Arch Calcification and Arterial Stiffness are Independent Factors for Diastolic Left Ventricular Dysfunction in Chronic Hemodialysis Patients
Aortic Arch Calcification and Arterial Stiffness are Independent Factors for Diastolic Left Ventricular Dysfunction in Chronic Hemodialysis Patients
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DOI：
10.1253/circj.cj-08-0308
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发表时间：
2008-11-01
影响因子：
3.3
通讯作者：
Nitta, Kosaku
中科院分区：
文献类型：
--
作者：
Fujiu, Ayuko;Cigawa, Tetsuya;Nitta, Kosaku
由于心血管疾病是透析患者死亡的主要原因，舒张期左心室（LV）功能障碍和动脉硬化，包括胸主动脉钙化之间的相关性，在慢性血液透析（HD）patients.Methods和结果纳入研究的对象是142（73名男性，69名女性）维持性血液透析患者。用MDCT测量主动脉弓钙化体积（AoACV），用臂踝脉搏波传导速度（PWV）测量动脉僵硬度，用组织多普勒成像结合心脏超声测量左室舒张功能（E/E'）。E/E'与收缩压（r=0.29，p=0.037）、年龄（r=0.19，p=0.02）、左室质量指数（r=0.18，p=0.036）、透析年限（r=0.19，p=0.037）、AoACV（r=0.37，p < 0.0001）和PWV（r=0.33，p=0.0002）显著相关。多元回归分析显示，AoACV（β =0.26，p=0.005）和PWV（β =0.22，p=0.03）是影响E/E '的独立因素。结论慢性血液透析患者左室舒张功能障碍可能与血管钙化增加和动脉僵硬度降低有关。(Circ J 2008; 72：1768-1772）
Background Because cardiovascular disease is the major cause of death in dialysis patients, the correlation between diastolic left ventricular (LV) dysfunction and arterial sclerosis, including thoracic aortic calcification, was studied in chronic hemodialysis (HD) patients.Methods and Results The enrolled study subjects were 142 (73 men, 69 women) maintenance HD patients. Aortic arch calcification volume (AoACV) was measured by MDCT scan, arterial stiffness was estimated by brachial-ankle pulse wave velocity (PWV) and diastolic LV function was estimated as E/E' by tissue Doppler imaging with cardiac ultrasonography. E/E' correlated significantly with systolic blood pressure (r=0.29, p=0.037), age (r=0.19, p=0.02) LV mass index (r=0.18, p=0.036), dialysis vintage (r=0.19, p=0.037), AoACV (r=0.37, p < 0.0001) and PWV (r=0.33, p=0.0002). Multiple regression analysis indicated that AoACV (beta=0.26, p=0.005) and PWV (beta=0.22, p=0.03) were independent determinants of E/E'.Conclusion Diastolic LV dysfunction may be induced by increased vascular calcification and reduced arterial stiffness in chronic HD patients. (Circ J 2008; 72: 1768-1772)