Abstract: SA-PO380
Evaluation of Myocardial Ischemia in Maintenance Hemodialysis Patients
Session Information
- Hemodialysis and Frequent Dialysis: CV and Risk Prediction
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Zhuang, Bing, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Luo, Yuan, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Wei, Guiling, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Ye, Hong, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Yang, Junwei, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
Background
Myocardial ischemia is a common and complex phenomenon in maintenance hemodialysis patients; however, their clinical manifestations are very insidious. The main purpose of this study was to analysis and evaluate myocardial ischemia in in our dialysis center, explore the influencing factors and propose effective intervention measures.
Methods
This study is a prospective study. From January 2022 to April 2022, 306 patients on maintenance hemodialysis were enrolled the research in our center. The patients completed cardiovascular assessment, including: data collection of hemodialysis, six-minute walk test(6-MWT), electrocardiogram before and after 6-MWT, and body composition analysis and noninvasive hemodynamic assessment. One third patients received coronary computed tomography angiography（CTA) and fraction flow reservation(CT-FFR).
Results
Among the 306 hemodialysis patients, 44% had abnormal electrocardiogram, manifested as abnormal ST segment, abnormal T wave, abnormal Q wave and arrhythmia. 8.8% of the patients had obvious myocardial ischemia after 6-minute walk test. 59% of patients had more severe coronary artery disease with coronary artery disease-reporting and data system (CAD-RADS) score of 3 and 4. Only 13% of the patients had chest pain symptoms, and 88.4% of the patients denied the history of coronary heart disease.
Coronary stenosis was mainly in the right coronary artery and left anterior descending artery. Severe stenosis was mainly positively correlated with age (R=0.19, P=0.00), calcium score (R=0.27, p<0.00), and six-minute walking distance (R=0.13, P=0.00) was negatively correlated. FFR showed that the fraction of coronary flow reserve in the left anterior descending artery decreased the most, which was mainly related to left ventricular septal hypertrophy (r=0.10, P=0.01), systolic blood pressure (r=0.15, P=0.00), cards score (r=0.31, P<0.00) and calcification score (r=0.34, P<0.00).
Conclusion
The incidence of myocardial ischemia patients in our dialysis center is common and insidious, however, the incidence of coronary stenosis is high. The stenosis was mainly in the right coronary artery and the left anterior descending artery, and the decrease of the coronary flow reserve was mainly in the left anterior descending artery. Both coronary stenosis and decreased fractional flow reserve were associated with higher coronary calcium scores.
Funding
- Government Support – Non-U.S.