Vascular calcification

Christian, Rose C.; Fitzpatrick, Lorraine A.

doi:10.1097/00041552-199907000-00008

Cited by 52 publications

(28 citation statements)

References 43 publications

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“…It is however important to caution that even though certain factors may be common to the pathogenesis of valvular calcification and atherosclerotic calcification, the pathogenesis of valvular or vascular calcification in the ESRD patients treated by dialysis is likely differ- ent from the atherosclerotic calcification observed in the general population. This is evidenced by the difference in the pattern of calcification with mineral deposition mainly in the tunica media for the ESRD in contrast to calcification of the atherosclerotic plaque in the non-ESRD patients (17)(18). Hence, whether the significant association demonstrated between mitral annulus calcification and the severity of carotid (19) and aortic atheroma (10), peripheral (20) as well as coronary artery disease (21) in the general population is also applicable to patients on dialysis requires further determination.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Valve Calcification as an Important Predictor for All-Cause Mortality and Cardiovascular Mortality in Long-Term Peritoneal Dialysis Patients

Wang

Woo³

et al. 2003

Journal of the American Society of Nephrology

364

237

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Abstract. Calcification complications are frequent among longterm dialysis patients. However, the prognostic implication of cardiac valve calcification in this population is not known. This study aimed to determine if cardiac valve calcification predicts mortality in long-term dialysis patients. Baseline echocardiography was performed in 192 patients (mean Ϯ SD age, 55 Ϯ 12 yr) on continuous ambulatory peritoneal dialysis (mean Ϯ SD duration of dialysis, 39 Ϯ 31 mo) to screen for calcification of the aortic valve, mitral valve, or both. Valvular calcification was present in 62 patients. During the mean follow-up of 17.9 mo (range, 0.6 to 33.9 mo), 46 deaths (50% of cardiovascular causes) were observed. Overall 1-yr survival was 70% and 93% for patients with and without valvular calcification (P Ͻ 0.0001, log-rank test). Cardiovascular mortality was 22% and 3% for patients with and without valvular calcification (P Ͻ 0.0001). Multivariable Cox regression analysis showed that cardiac valve calcification was predictive of an increased allcause mortality (hazard ratio [HR], 2.50; 95% CI, 1.32 to 4.76; P ϭ 0.005) and cardiovascular death (HR 5.39; 95% CI, 2.16 to 13.48; P ϭ 0.0003) independent of age, male gender, dialysis duration, C-reactive protein, diabetes, and atherosclerotic vascular disease. Eighty-nine percent of patients with both valvular calcification and atherosclerotic vascular disease, 23% of patients with valvular calcification only, 21% of patients with atherosclerotic vascular disease only, and 13% of patients with neither complication died at 1-yr (P Ͻ 0.0005). The cardiovascular death rate was 85% for patients with both complications, 13% for patients with valvular calcification only, 14% for patients with atherosclerotic vascular disease only, and 5% for those with neither complication (P Ͻ 0.0005). The number of calcified valves was associated with all-cause mortality (P Ͻ 0.0005) and cardiovascular death (P Ͻ 0.0005). One-year all-cause mortality was 57% for patients with both aortic and mitral valves calcified, 40% for those with either valve calcified, and 15% for those with neither valve calcified. In conclusion, cardiac valve calcification is a powerful predictor for mortality and cardiovascular deaths in long-term dialysis patients. Valvular calcification by itself has similar prognostic importance as the presence of atherosclerotic vascular disease. Its coexistence with other atherosclerotic complications indicates more severe disease and has the worst outcome. awang@cuhk.edu.hkVascular or tissue calcification is increasingly recognized to be a frequent complication in patients with end-stage renal disease (ESRD). Braun et al. (1) reported that two thirds of the adult hemodialysis patients had electron beam computed tomographic (EBCT) evidence of coronary artery calcification (CAC) and that over half had cardiac valve calcification. The calcification score in dialysis patients was not only substantially higher than age-matched and gender-matched patients with angiographically confirmed c...

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Section: Discussionmentioning

confidence: 99%

Cardiac Valve Calcification as an Important Predictor for All-Cause Mortality and Cardiovascular Mortality in Long-Term Peritoneal Dialysis Patients

Wang

Woo³

et al. 2003

Journal of the American Society of Nephrology

364

237

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“…In the form of a poor crystalline, non-stoichiometric, ion-substituted CDHA (commonly referred to as "biological apatite"), calcium orthophosphates are present in bones, teeth, deer antlers and tendons of mammals to give these organs stability, hardness and function [2,4,5]. Through we still do not exactly know why the highly intelligent animals use conformable calcium orthophosphates as their crucial biomineral for survival [6], current biomedical questions of persistent pathological and physiological mineralization in the body force people to focus on the processes, including the occurrence, formation and degradation of calcium orthophosphates in living organisms [7,8,9].…”

Section: Introductionmentioning

confidence: 99%

Nanodimensional and Nanocrystalline Calcium Orthophosphates

Dorozhkin¹

2012

AJBE

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Nano-sized particles and crystals play an important role in the formation of calcified tissues of various animals. For example, nano-sized and nanocrystalline calcium orthophosphates in the form of apatites of biological origin represent the basic inorganic building blocks of bones and teeth of mammals. Namely, according the recent developments in biomineralization, tens to hundreds nanodimensional crystals of a biological apatite are self-assembled into these complex structures. This process occurs under a strict control by bioorganic matrixes. Furthermore, both a greater viability and a better proliferation of various types of cells have been detected on smaller crystals of calcium orthophosphates. Thus, the nano-sized and nanocrystalline forms of calcium orthophosphates have a great potential to revolutionize the hard tissue-engineering field, starting from bone repair and augmentation to controlled drug delivery systems. This review reports on current state of the art and recent developments on the subject, starting from synthesis and characterization to biomedical and clinical applications. Furthermore, the review also discusses possible directions for future research and development.

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“…8 Hematopoietic marrow has been found in artery walls of 9 of 200 cases. 4 Cartilage tissue is also found within human atherosclerotic plaque, 9 but its frequency has not been systematically assessed.…”

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confidence: 99%

Mesenchymal Stem Cells and the Artery Wall

Abedin

Tintut

Demer

2004

Circulation Research

201

125

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Abstract-The presence of ectopic tissue in the diseased artery wall is evidence for the presence of multipotential stem cells in the vasculature. Mesenchymal stem cells were first identified in the marrow stroma, and they differentiate along multiple lineages giving rise to cartilage, bone, fat, muscle, and vascular tissue in vitro and in vivo. Transplantation studies show that marrow-derived mesenchymal stem cells appear to enter the circulation and engraft other tissues, including the artery wall, at sites of injury. Recent evidence indicates that mesenchymal stem cells are also present in normal artery wall and microvessels and that they also may enter the circulation, contributing to the population of circulating progenitor cells and engrafting other tissues. Thus, the artery wall is not only a destination but also a source of progenitor cells that have regenerative potential. Although potential artifacts, such as fusion, need to be taken into consideration,

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Vascular calcification

Cited by 52 publications

References 43 publications

Cardiac Valve Calcification as an Important Predictor for All-Cause Mortality and Cardiovascular Mortality in Long-Term Peritoneal Dialysis Patients

Cardiac Valve Calcification as an Important Predictor for All-Cause Mortality and Cardiovascular Mortality in Long-Term Peritoneal Dialysis Patients

Nanodimensional and Nanocrystalline Calcium Orthophosphates

Mesenchymal Stem Cells and the Artery Wall

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