Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Valvular Heart Disease
Echocardiographic Assessment of Cardiac Structural and Functional Abnormalities in Patients With End-Stage Renal Disease Receiving Chronic Hemodialysis
Hiroshi Matsuo, Kaoru Dohi, Hirofumi Machida, Hideyuki Takeuchi, Toshikazu Aoki, Hiroyuki Nishimura, Masashi Yasutomi, Michiharu Senga, Takehiko Ichikawa, Kentaro Kakuta, Yasuhide Mizutani, Akiko Tanoue, Naoki Isaka, Kazuki Oosugi, Sukenari Koyabu, Masato Sakurai, Yoshihisa Fukui, Hitoshi Kakimoto, Tadafumi Sugimoto, Takahiro Ohnishi, Tomohiro Murata, Eiji Ishikawa, Ryuji Okamoto, Tomomi Yamada, Toru Ogura, Yuki Nishimura, Takashi Tanigawa, Shinsuke Nomura, Masakatsu Nishikawa, Masaaki Ito
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Keywords: Aortic valve sclerosis, Echocardiography, End-stage renal disease, Hemodialysis, Left ventricle
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2018 Volume 82 Issue 2 Pages 586-595

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Abstract

Background:The aim of this study was to assess the echocardiographic characteristics of chronic hemodialysis (HD) patients with end-stage renal disease (ESRD) in a multicenter prospective cohort study.

Methods and Results:Three hundred and fifteen patients with ESRD (67.9±10.6 years, 47.6% male) on chronic HD for ≥1 year were examined on transthoracic echocardiography, including Doppler-derived aortic valve area (AVA) measurement. Only 11.5% and 3.4% of all patients had normal left ventricular (LV) geometry and normal LV filling pattern, respectively. The majority of patients had aortic and mitral valvular calcification, and approximately 50% of all 315 patients had aortic valve narrowing with AVA <2.0 cm2. Patients were divided into 3 groups according to AVA index tertile: group 1, highest tertile; group 2, middle tertile; and group 3, lowest tertile. Group 3 was older, had a greater cardiothoracic ratio on chest X-ray, higher plasma brain natriuretic peptide and total LV afterload, and lower stroke volume index than the other 2 groups. Age and intact parathyroid hormone (PTH) level were independently associated with low AVA index.

Conclusions:Patients with ESRD on chronic HD have a high prevalence of cardiac structural and functional abnormalities including calcified aortic sclerosis. High age and PTH were associated with aortic valve narrowing in these patients.

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© 2018 THE JAPANESE CIRCULATION SOCIETY
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Japanese Circulation Journal

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