Combined cardiomegaly and aortic arch calcification predict mortality in hemodialysis patients

Ther Apher Dial. 2023 Feb;27(1):31-38. doi: 10.1111/1744-9987.13902. Epub 2022 Jul 2.

Abstract

Introduction: This study aimed to investigate the relationship between cardiomegaly and aortic arch calcification (AAC) and overall/cardiovascular mortality in hemodialysis patients.

Methods: We conducted a retrospective cohort study and enrolled patients who underwent initial hemodialysis. Cardiomegaly and AAC were determined by chest radiography and classified into four groups according to cross-classification of cardiothoracic ratio (CTR) of 0.5 and lower/higher grade AAC (LGAAC/HGAAC). The relationship between these groups and mortality was then analyzed by Cox proportional hazards model.

Results: In multivariate Cox regression analysis, those in CTR ≤ 0.5 and HGAAC [hazard ratio (95% confidence interval): 2.07 (1.14-3.77)], CTR > 0.5 & LGAAC [3.60 (2.07-6.25)] and CTR > 0.5 & HGAAC [3.42 (2.03-5.77)] were significantly associated with overall mortality; while those in CTR > 0.5 & LGAAC [2.81 (1.28-6.19)] and CTR > 0.5 & HGAAC [2.32 (1.09-4.95)] were significantly related to cardiovascular mortality.

Conclusion: Combined cardiomegaly and AAC predicted overall and cardiovascular mortality in hemodialysis patients.

Keywords: artic arch calcification; cardiomegaly; cardiovascular mortality; hemodialysis; overall mortality.

MeSH terms

  • Aorta, Thoracic* / diagnostic imaging
  • Cardiomegaly
  • Humans
  • Radiography
  • Renal Dialysis
  • Retrospective Studies
  • Risk Factors
  • Vascular Calcification* / diagnostic imaging