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Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients.

https://arctichealth.org/en/permalink/ahliterature298110
Source
Perit Dial Int. 2018 Sep-Oct; 38(5):366-373
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Author
Satu Mäkelä
Markku Asola
Henrik Hadimeri
James Heaf
Maija Heiro
Leena Kauppila
Susanne Ljungman
Mai Ots-Rosenberg
Johan V Povlsen
Björn Rogland
Petra Roessel
Jana Uhlinova
Maarit Vainiotalo
Maria K Svensson
Heini Huhtala
Heikki Saha
Author Affiliation
Tampere University Hospital, Tampere, Finland satu.m.makela@pshp.fi.
Source
Perit Dial Int. 2018 Sep-Oct; 38(5):366-373
Language
English
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Ankle Brachial Index
Aorta, Abdominal - diagnostic imaging
Aortic Diseases - diagnosis - epidemiology - etiology
Cause of Death - trends
Critical Illness - mortality - therapy
Denmark - epidemiology
Estonia - epidemiology
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Peritoneal Dialysis - adverse effects - mortality
Prognosis
Prospective Studies
Renal Dialysis
Risk factors
Survival Rate - trends
Sweden - epidemiology
Ultrasonography, Doppler
Vascular Calcification - diagnosis - epidemiology - etiology
Abstract
Peripheral arterial disease and vascular calcifications contribute significantly to the outcome of dialysis patients. The aim of this study was to evaluate the prognostic role of severity of abdominal aortic calcifications and peripheral arterial disease on outcome of peritoneal dialysis (PD) patients using methods easily available in everyday clinical practice.
We enrolled 249 PD patients (mean age 61 years, 67% male) in this prospective, observational, multicenter study from 2009 to 2013. The abdominal aortic calcification score (AACS) was assessed using lateral lumbar X ray, and the ankle-brachial index (ABI) using a Doppler device.
The median AACS was 11 (range 0 - 24). In 58% of the patients, all 4 segments of the abdominal aorta showed deposits, while 19% of patients had no visible deposits (AACS 0). Ankle-brachial index was normal in 49%, low ( 1.3) in 34% of patients. Altogether 91 patients (37%) died during the median follow-up of 46 months. Only 2 patients (5%) with AACS 0 died compared with 50% of the patients with AACS = 7 (p
PubMed ID
29386304 View in PubMed
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High long-term morbidity in repaired aortic coarctation: weak association with residual arch obstruction.

https://arctichealth.org/en/permalink/ahliterature130345
Source
Congenit Heart Dis. 2011 Nov-Dec;6(6):573-82
Publication Type
Article
Author
Thais A L Pedersen
Kim Munk
Niels H Andersen
Erik Lundorf
Erling B Pedersen
Vibeke E Hjortdal
Kristian Emmertsen
Author Affiliation
Departments of Cardiothoracic and Vascular Surgery Cardiology Radiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. thais.a.pedersen@ki.au.dk
Source
Congenit Heart Dis. 2011 Nov-Dec;6(6):573-82
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antihypertensive Agents - therapeutic use
Aorta, Thoracic - pathology - physiopathology - radiography - surgery - ultrasonography
Aortic Coarctation - complications - epidemiology - physiopathology - surgery
Aortic Diseases - diagnosis - epidemiology - etiology - physiopathology - therapy
Aortography - methods
Blood pressure
Blood Pressure Monitoring, Ambulatory
Cardiac Surgical Procedures - adverse effects
Chi-Square Distribution
Child
Child, Preschool
Denmark - epidemiology
Exercise Test
Exercise Tolerance
Female
Heart Diseases - epidemiology - etiology
Humans
Hypertension - epidemiology - etiology
Infant
Logistic Models
Magnetic Resonance Angiography
Male
Middle Aged
Prevalence
Reoperation
Risk assessment
Risk factors
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
Abstract
The objective of this study was to assess late morbidity after repair of aortic coarctation and its association with residual aortic arch obstruction.
This is an observational cohort study of 133 patients who underwent surgical repair during 1965-1985. Echocardiography, bicycle exercise testing, 24-hour ambulatory blood pressure monitoring, and magnetic resonance imaging/computerized tomography scan of the thoracic aorta were performed. The setting of this study was a tertiary referral center.
Among 156 survivors, 133 (84 men) accepted study participation. Median age (range) was 10 (0.1-40) years at repair and 44 (26-74) years at follow-up.
Outcome measures used are prevalence of previous cardiovascular reinterventions, current cardiac and valvular function, exercise capacity, blood pressure levels at rest and during exercise, and presence of recurrent or residual aortic arch obstruction and/or aortic aneurysms.
Thirty-five had undergone cardiovascular reinterventions. Sixteen had an aortic and three had a mitral valve prosthesis; 117 had a native aortic valve that was bicuspid in 63 and dysfunctional in 45. Ejection fraction was below 50% in 16. On exercise, performance was reduced in 37 and hypertension was induced in 47. Fifty-eight had elevated blood pressures and further 17 received antihypertensives. The ascending aorta was aneurysmal in 28 and the distal arch in five. The presence of a bicuspid aortic valve was significantly associated with valve regurgitation and ascending aortic ectasia. Fifty-eight of 121 patients had minimal aortic arch diameters between 46% and 79% of the diaphragmatic aortic diameter, indicating moderate/mild recoarctation. This was associated with elevated blood pressures and use of antihypertensive medication, but not with hypertension in unmedicated patients or with echocardiographic or exercise parameters. Only five patients had normal study findings, were normotensive, and without reinterventions after coarctation repair.
Cure by repair of aortic coarctation is rare; heart diseases, aortopathy, and hypertension are common. Morbidity is only weakly associated with mild/moderate recoarctation.
PubMed ID
22011266 View in PubMed
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