#1703 Annual aortic valve velocity as a predictor of systemic calcification and mortality: a novel monitoring approach in dialysis

OpenAlex İngilizce

Abstract Background and Aims Valvular calcification is concordant with vascular calcification and develops faster in end-stage renal disease patients than in the average population. There are contradictory reports about the pathophysiology and the predictive value of valvular calcification regarding mortality in this patient population. Aortic peak wave velocity (Vmax) measurement is a non-invasive and reliable marker for the diagnosis of valve calcification. Our study analyzes the cardiovascular risk prediction effect of increasing levels of Vmax at different time points in dialysis patients. Method We conducted a retrospective, single-center study of incident hemodialysis and peritoneal dialysis patients under follow-up between January 1990 and December 2024 in our clinic. Demographics, laboratory, and echocardiographic findings were obtained from medical records. Patients without a baseline echocardiography were excluded. ΔVmax is defined as the last Vmax minus baseline Vmax levels. The patients were divided into two subgroups: Vmax-stable and Vmax-increased. Results The baseline demographics, laboratory, and clinical characteristics, including daily elemental calcium and calcitriol or paricalcitol usage, were similar between Vmax-stable and Vmax-increased groups. Annual CaXP levels were significantly and longitudinally higher in the Vmax-increased group. The within-subject effect of the groups was insignificant (F [3.65, 86.91] = 0.851, P = 0.49). The between-subjects effects of the groups were significant, with overall higher values in Vmax increased group (F [1, 80] = 6.86, P = 0.01). Cardiovascular mortality was 9.2% in the Vmax-stable group and 23% in the Vmax-increased group within a median of 11 (IQR: 6–18) years of follow-up of the study population (P = 0.02). Conclusion During a follow-up of 24 years, increasing Vmax values were associated with longitudinally higher CaxP levels and mortality in dialysis patients. Even if the increase is subclinical, Vmax follow-up is a non-invasive, easily accessible method and might identify the high-risk group regarding cardiovascular mortality in the dialysis population.