Vascular calcification is associated with an adverse prognosis in end-stage renal disease. It can be accurately quantitated with computed tomography but simple in-office techniques may provide equally useful information. Accordingly we compared the results obtained with simple non-invasive techniques with those obtained using electron beam tomography (EBT) for coronary artery calcium scoring (CACS) in 140 prevalent hemodialysis patients. All patients underwent EBT imaging, a lateral X-ray of the lumbar abdominal aorta, an echocardiogram, and measurement of pulse pressure (PP). Calcification of the abdominal aorta was semiquantitatively estimated with a score (Xr-score) of 0-24 divided into tertiles, echocardiograms were graded as 0-2 for absence or presence of calcification of the mitral and aortic valve and PP was divided in quartiles. The CACS was elevated (mean 910+/-1657, median 220). The sensitivity and specificity for CACS > or = 100 was 53 and 70%, for calcification of either valve and 67 and 91%, respectively, for Xr-score > or = 7. The area under the curve for CACS > or = 100 associated with valve calcification and Xr-score was 0.62 and 0.78, respectively. The likelihood ratio (95% confidence interval) of CACS > or = 100 was 1.79 (1.09, 2.96) for calcification of either valve and 7.50 (2.89, 19.5) for participants with an Xr-score > or = 7. In contrast, no association was present between PP and CACS. In conclusion, simple measures of cardiovascular calcification showed a very good correlation with more sophisticated measurements obtained with EBT. These methodologies may prove very useful for in-office imaging to guide further therapeutic choices in hemodialysis patients. Comment in Can we simplify the measurement of cardiovascular calcification in hemodialysis patients? [Nat Clin Pract Nephrol. 2007] Vascular calcification: Hardening of the evidence. [Kidney Int. 2006] Can we simplify the measurement of cardiovascular calcification in patients on hemodialysis? [Nat Clin Pract Cardiovasc Med. 2007]

Correlation of simple imaging tests and coronary artery calcium measured by computed tomography in hemodialysis patients / A. Bellasi, E. Ferramosca, P. Muntner, C. Ratti, R.P. Wildman, G.A. Block, P. Raggi. - In: KIDNEY INTERNATIONAL. - ISSN 0085-2538. - 70:9(2006 Nov), pp. 1623-1628.

Correlation of simple imaging tests and coronary artery calcium measured by computed tomography in hemodialysis patients

A. Bellasi
Primo
;
2006-11

Abstract

Vascular calcification is associated with an adverse prognosis in end-stage renal disease. It can be accurately quantitated with computed tomography but simple in-office techniques may provide equally useful information. Accordingly we compared the results obtained with simple non-invasive techniques with those obtained using electron beam tomography (EBT) for coronary artery calcium scoring (CACS) in 140 prevalent hemodialysis patients. All patients underwent EBT imaging, a lateral X-ray of the lumbar abdominal aorta, an echocardiogram, and measurement of pulse pressure (PP). Calcification of the abdominal aorta was semiquantitatively estimated with a score (Xr-score) of 0-24 divided into tertiles, echocardiograms were graded as 0-2 for absence or presence of calcification of the mitral and aortic valve and PP was divided in quartiles. The CACS was elevated (mean 910+/-1657, median 220). The sensitivity and specificity for CACS > or = 100 was 53 and 70%, for calcification of either valve and 67 and 91%, respectively, for Xr-score > or = 7. The area under the curve for CACS > or = 100 associated with valve calcification and Xr-score was 0.62 and 0.78, respectively. The likelihood ratio (95% confidence interval) of CACS > or = 100 was 1.79 (1.09, 2.96) for calcification of either valve and 7.50 (2.89, 19.5) for participants with an Xr-score > or = 7. In contrast, no association was present between PP and CACS. In conclusion, simple measures of cardiovascular calcification showed a very good correlation with more sophisticated measurements obtained with EBT. These methodologies may prove very useful for in-office imaging to guide further therapeutic choices in hemodialysis patients. Comment in Can we simplify the measurement of cardiovascular calcification in hemodialysis patients? [Nat Clin Pract Nephrol. 2007] Vascular calcification: Hardening of the evidence. [Kidney Int. 2006] Can we simplify the measurement of cardiovascular calcification in patients on hemodialysis? [Nat Clin Pract Cardiovasc Med. 2007]
Adult; Aged; Blood Pressure; Bone Density; Calcinosis; Calcium; Chronic Disease; Coronary Artery Disease; Coronary Vessels; Echocardiography; Female; Humans; Kidney Diseases; Male; Middle Aged; Renal Dialysis; Risk Factors; Sensitivity and Specificity; Tomography, X-Ray Computed
Settore MED/14 - Nefrologia
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/256224
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