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    Aortic Calcification and Femoral Bone Density Are Independently Associated with Left Ventricular Mass in Patients with Chronic Kidney Disease

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    Authors
    Chue, Colin D.
    Wall, Nadezhda A.
    Crabtree, Nicola J.
    Zehnder, Daniel
    Moody, William E.
    Edwards, Nicola C.
    Steeds, Richard P.
    Townend, Jonathan N.
    Ferro, Charles J.
    Issue Date
    2012-06-18
    URI
    http://hdl.handle.net/10675.2/799
    
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    Abstract
    Background: Vascular calcification and reduced bone density are prevalent in chronic kidney disease and linked to increased cardiovascular risk. The mechanism is unknown. We assessed the relationship between vascular calcification, femoral bone density and left ventricular mass in patients with stage 3 non-diabetic chronic kidney disease in a cross-sectional observational study.
    Methodology and Principal Findings: A total of 120 patients were recruited (54% male, mean age 55(+/-)14 years, mean glomerular filtration rate 50(+/-)13 ml/min/1.73 m2). Abdominal aortic calcification was assessed using lateral lumbar spine radiography and was present in 48%. Mean femoral Z-score measured using dual energy x-ray absorptiometry was 0.60(+/-)1.06. Cardiovascular magnetic resonance imaging was used to determine left ventricular mass. One patient had left ventricular hypertrophy. Subjects with aortic calcification had higher left ventricular mass compared to those without (56(+/-)16 vs. 48(+/-)12 g/m2, P = 0.002), as did patients with femoral Z-scores below zero (56(+/-)15 vs. 49(+/-)13 g/m2, P = 0.01). In univariate analysis presence of aortic calcification correlated with left ventricular mass (r = 0.32, P = 0.001); mean femoral Zscore inversely correlated with left ventricular mass (r =20.28, P = 0.004). In a multivariate regression model that included presence of aortic calcification, mean femoral Z-score, gender and 24-hour systolic blood pressure, 46% of the variability in left ventricular mass was explained (P<0.001).
    Conclusions: In patients with stage 3 non-diabetic chronic kidney disease, lower mean femoral Z-score and presence of aortic calcification are independently associated with increased left ventricular mass. Further research exploring the pathophysiology that underlies these relationships is warranted.
    Citation
    PLoS One. 2012 Jun 18; 7(6):e39241
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pone.0039241
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    Department of Pathology: Faculty Research and Presentations

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