Differences in associated factors between aortic and mitral valve calcification in hemodialysis

• Published in: Hypertension research Vol. 33; no. 6; pp. 622 - 626
• Main Authors: Ikee, Ryota, Honda, Kenjiro, Ishioka, Kunihiro, Oka, Machiko, Maesato, Kyoko, Moriya, Hidekazu, Hidaka, Sumi, Ohtake, Takayasu, Kobayashi, Shuzo
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.06.2010
• Subjects: 692/420; 692/699/75/593/2193; 692/700/565/1950/1544; Adult; Aged; Aged, 80 and over; Aortic Valve - diagnostic imaging; Aortic Valve - pathology; beta 2-Microglobulin - blood; C-Reactive Protein - analysis; Calcinosis - blood; Calcinosis - diagnostic imaging; Calcinosis - pathology; Calcium - blood; Cardiomyopathies - diagnostic imaging; Cardiomyopathies - pathology; cardiovascular disease; Cholesterol - blood; Dyslipidemias - physiopathology; Female; Geriatrics/Gerontology; Health Promotion and Disease Prevention; Heart Valve Diseases - blood; Heart Valve Diseases - diagnostic imaging; Heart Valve Diseases - pathology; hemodialysis; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Mitral Valve - diagnostic imaging; Mitral Valve - pathology; Obstetrics/Perinatology/Midwifery; original-article; Public Health; Renal Dialysis - adverse effects; Serum Albumin - analysis; Ultrasonography; valve calcification; β_2-microglobulin; microglobulin; hemodialysis; valve calcification; cardiovascular disease; β
• ISSN: 0916-9636; 1348-4214; 1348-4214
• DOI: 10.1038/hr.2010.44

Increased prevalence of aortic and mitral valve calcification has been reported in patients on hemodialysis, but it remains unknown whether aortic and mitral valve calcification arise from similar pathogenesis. We detected heart valve calcification using two-dimensional echocardiography, and we related valve calcification to various clinical parameters in patients treated with hemodialysis three times a week for more than 1 year. In 112 patients (77 men and 35 women, age 67±10 years, duration on hemodialysis 95±67 months), aortic and mitral valve calcification were observed in 84 (75.0%) and 58 (51.7%) patients, respectively. Aortic valve calcification was associated with increased age, higher serum calcium, lower serum albumin, lower total cholesterol and higher high-sensitivity C-reactive protein. Multivariate analysis showed that increased age and higher serum calcium were independently associated with aortic valve calcification. Conversely, mitral valve calcification was associated with increased age, higher high-sensitivity C-reactive protein and higher serum β 2 -microglobulin, but not with higher serum calcium. In multivariate analysis, increased age and higher serum β 2 -microglobulin were independently associated with mitral valve calcification. Serum β 2 -microglobulin was associated with longer duration on hemodialysis, malnutrition inflammation (lower serum albumin and higher high-sensitivity C-reactive protein) and dyslipidemia. Considering the results in previous studies showing that the distribution of β 2 -microglobulin amyloid deposition was consistent with that of tissue calcification in patients on hemodialysis, β 2 -microglobulin may have pathogenic roles in valve calcification.