Simple evaluation of aortic arch calcification by chest radiography in hemodialysis patients

Abstract

Vascular calcification is associated with a poor prognosis in dialysis patients. It can be assessed with computed tomography but simple inoffice techniques may provide useful information. We compared the results obtained with a simple noninvasive technique with those obtained using multidetector computed tomography for aortic arch calcification volume (AoACV) in chronic hemodialysis (HD) patients. The enrolled study subjects were 63 (32 men and 31 women) maintenance HD patients. Calcification of the aortic arch was semiquantitatively estimated with a AoAC score (AoACS) on plain chest radiology. The AoACV was increased, with a mean value of 6.6 ranging from 0% to 36.5%. The coefficient of intraobserver variation was less than 2.5%. Aortic arch calcification score was highly correlated with AoACV (r=0.635, P<0.001). Multiple regression analysis showed age (F value=12.62, P<0.001) and pulse pressure (F value=4.54, P=0.037) to be significant independent determinants of AoACS. In conclusion, a simple measurement of AoACS may be useful for inoffice imaging to choose a therapeutic regimen in HD patients.

Serum Fibroblast Growth Factor-23 Levels and Progression of Aortic Arch Calcification in Non-Diabetic Patients on Chronic Hemodialysis

“…The coefficient of intra-observer variation was 2.1% and 2.2% in two radiologists. As previously described 18) , AoACS was highly correlated with AoAC volume estimated by multi-detector computed tomography (MDCT) (r 0.635, p 0.001). Any differences between radiologist interpretations were resolved by consensus of a committee of three additional investigators who also were blinded to the study protocol.…”

“…AoACS determination by plain chest radiography was performed at the start of HD therapy. As pre- viously described 18,19) , the validity of AoACS was confirmed. The results from the present study suggest that the AoACS value at baseline correlated positively with age and dialysis duration, suggesting that they followed the common progress of aortic atherosclerosis 20) .…”

“…Radiographs were assessed for the presence of AoAC using a specific scale. As previously described 18) , the scale, which was divided into 16 circumferences, was attached to the aortic arch on chest radiography and then the number of sectors with calcification was divided by 16. The aortic arch calcification score (AoACS) was calculated after multipliying by 100 to express the results as a percentage.…”

Vascular Calcification on Plain Radiographs Is Related with the Severity of Lesions Detected by Coronary Angiography in Dialysis Patients

“…VC scores were estimated using previously reported methods (Adragao et al 2004;Honkanen et al 2008;An et al 2009An et al , 2010Ogawa et al 2009;Nitta and Ogawa 2011;Verbeke et al 2011).…”

“…Previous studies illustrated that high or meaningful VC scores of artery or aorta on plain radiographs are associated with CAD events in dialysis patients. (Blacher et al 2001;Adragao et al 2004;An et al 2009An et al , 2010Ogawa et al 2009;Nitta and Ogawa 2011;An and Son 2013;Kwon et al 2014).…”