Mitral Annular Calcification is Associated with Reduced Left Ventricular Function and Inflammation in Patients with Chronic Kidney Disease

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Abstract

Background

Mitral annular calcification (MAC) is prevalent in patients with chronic kidney disease (CKD); however, it is not known whether the increased cardiovascular risk observed in patients with CKD and MAC is related to atherosclerotic burden, because they share common risk factors.

Methods

Transthoracic echocardiography was performed in patients with CKD undergoing pre-kidney transplantation evaluation. Fasting lipids, high-sensitivity C-reactive protein, parathyroid hormone, calcium, and creatinine levels were measured.

Results

Of 99 participants, the 31 with MAC had higher carotid intima-media thickness (P= .004), lower left ventricular ejection fraction (P= .016), and higher high-sensitivity C-reactive protein (P= .01). MAC was predicted independently by increasing high-sensitivity C-reactive protein, decreasing left ventricular ejection fraction, and not being on dialysis (likelihood ratio 21.8,P< .001). Models were not affected significantly by the addition of age, carotid intima-media thickness, and other laboratory tests.

Conclusions

In patients with CKD, MAC is associated with inflammation, reduced left ventricular function, and treatment with dialysis, independent of the degree of subclinical atherosclerosis.

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