دورية أكاديمية

Epicardial fat and coronary artery calcification in patients on long-term hemodialysis.

التفاصيل البيبلوغرافية
العنوان: Epicardial fat and coronary artery calcification in patients on long-term hemodialysis.
المؤلفون: Gauβ S; From the Department of Cardiology, University of Erlangen, Erlangen, Germany., Klinghammer L, Jahn D, Schuhbäck A, Achenbach S, Marwan M
المصدر: Journal of computer assisted tomography [J Comput Assist Tomogr] 2014 Sep-Oct; Vol. 38 (5), pp. 768-72.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7703942 Publication Model: Print Cited Medium: Internet ISSN: 1532-3145 (Electronic) Linking ISSN: 03638715 NLM ISO Abbreviation: J Comput Assist Tomogr Subsets: MEDLINE
أسماء مطبوعة: Publication: <2000->: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: New York, Raven Press.
مواضيع طبية MeSH: Adiposity*, Calcinosis/*epidemiology , Coronary Artery Disease/*epidemiology , Pericardium/*diagnostic imaging , Renal Dialysis/*statistics & numerical data , Renal Insufficiency, Chronic/*epidemiology , Renal Insufficiency, Chronic/*therapy, Adipose Tissue/diagnostic imaging ; Adult ; Aged ; Calcinosis/diagnostic imaging ; Causality ; Coronary Angiography/statistics & numerical data ; Coronary Artery Disease/diagnostic imaging ; Female ; Germany/epidemiology ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Prevalence ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Tomography, X-Ray Computed/statistics & numerical data
مستخلص: Introduction: Recent studies have shown a significant correlation between increased epicardial fat volume (EFV) and mortality, coronary artery disease events, and measures of coronary atherosclerotic burden, for example, coronary calcium. Patients with chronic kidney disease on hemodialysis have an increased prevalence of coronary atherosclerosis and coronary calcium. The mechanisms underlying both may differ from patients with normal kidney function. Only limited data are available on the relationship between epicardial fat and coronary calcium in these patients.
Methods: Ninety-three consecutive patients (62 men and 31 women; mean age, 55 ± 11 years) with chronic kidney failure on regular hemodialysis underwent computed tomography for coronary calcium scoring as well as assessment of cardiovascular risk factors. Calcium scoring was performed using a low-dose, prospectively ECG-triggered high pitch spiral acquisition protocol (dual-source computed tomography, 280-millisecond (ms) rotation, 2 × 128 × 0.6-mm collimation, 120-kV tube voltage, 80-mA·s tube current). Cross-sectional images were reconstructed with 3.0-mm thickness, 1.5-mm increment, and a medium sharp reconstruction kernel (B35f). Agatston score and EVF were analyzed in a semiautomatic fashion using dedicated software.
Results: The mean duration of dialysis was 5.7 years. Of all patients, 93% had arterial hypertension, 66% had hyperlipidemia, 30% were diabetic, and 49.5% were current or prior smokers. The mean body mass index (BMI) was 27 ± 4 kg/m. The mean EFV was 162 ± 80 mL, and the mean coronary artery calcification (CAC) was 765 ± 1391 Agatston units (AU). In univariable and multivariable analysis, EFV was significantly correlated to BMI (P < 0.05) and age (P = 0.021), but not to CAC (P = 0.106). In subanalysis for values binned by median, we also found a significant correlation between EFV (binned) and smoking (P = 0.49) as well as a significant correlation between EFV (binned) and CAC for 46 patients younger than 55 years (median age).
Conclusion: The epicardial fat volume in patients with chronic kidney disease and on hemodialysis is significantly correlated to BMI, age, and smoking but, with the exception of younger patients, not to the coronary calcium score. Our data suggest that in this special patient cohort, other mechanisms might influence the genesis of coronary calcification.
تواريخ الأحداث: Date Created: 20140601 Date Completed: 20141118 Latest Revision: 20161125
رمز التحديث: 20221213
DOI: 10.1097/RCT.0000000000000113
PMID: 24879458
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-3145
DOI:10.1097/RCT.0000000000000113