{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T15:24:32Z","timestamp":1761578672622,"version":"3.37.3"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:00:00Z","timestamp":1622678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:00:00Z","timestamp":1622678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Clinical symptoms of patients on dialysis do not match the signs of coronary disease progression, making the prediction of the true progression of their medical condition in clinical settings difficult. Emergency and concomitant surgeries are significant risk factors of mortality following open-heart surgery in patients on hemodialysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>\n  We report two cases of successful coronary artery bypass grafting (CABG) in patients on dialysis with a history of cardiac surgery. The first case describes a 65-year-old woman who had undergone aortic valve replacement 2 years ago and was hospitalized urgently, because of a sudden decline in heart function and hypotension. She had moderate mitral regurgitation with right ventricular pressure of 66 mmHg and poor left ventricular function [left ventricular ejection fraction (LVEF), 40%]. Cineangiography revealed an increase in the rate of stenosis in the left main trunk, from 25 to 99% at admission, in addition to 100% occlusion in proximal left anterior descending artery (LAD) and 99% stenosis in the proximal left circumflex artery (LCX). We inserted an intra-aortic balloon pump preoperatively and performed emergency surgery (Euro II risk score, 61.7%; Society of Thoracic Surgeons (STS) risk score, 56.3%). The second case described a 78-year-old man who had undergone surgery for left atrial myxoma 4 years ago and was hospitalized urgently due to dyspnea, chest discomfort, and an LVEF of 44% (Euro II risk score, 40.7%; STS risk score, 33.2%). Cineangiography revealed an increase in the rate of stenosis in the proximal LAD, from 25% (4 years ago) to 90% at admission, in addition to 99% stenosis in proximal LCX and 95% stenosis in the posterolateral branch of LCX. Both patients underwent emergency CABG due to unstable hemodynamics and decreased left ventricular function despite regular dialysis. The surgeries were successful, and the patients were discharged without any complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In patients with multiple comorbidities and those who undergo dialysis treatment, calcified lesions in coronary arteries can progress severely and rapidly without any symptoms, including chest pain. Close outpatient management involving nephrologists and the cardiovascular team is necessary for patients on dialysis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12872-021-02076-5","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T11:09:23Z","timestamp":1622718563000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Rapid decline in cardiac function in diabetic patients with calcified coronary artery disease undergoing hemodialysis: two case reports"],"prefix":"10.1186","volume":"21","author":[{"given":"Hironobu","family":"Yamaoka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2214-2539","authenticated-orcid":false,"given":"Taira","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Endo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akie","family":"Shimada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Matsushita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tohru","family":"Asai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Amano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,3]]},"reference":[{"key":"2076_CR1","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1016\/0735-1097(90)90282-T","volume":"15","author":"AS Agatston","year":"1990","unstructured":"Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15:827\u201332.","journal-title":"J Am Coll Cardiol"},{"key":"2076_CR2","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/S0272-6386(96)90363-7","volume":"27","author":"J Braun","year":"1996","unstructured":"Braun J, Oldendorf M, Moshage W, Heidler R, Zeitler E, Luft FC. Electron beam computed tomography in the evaluation of cardiac calcification in chronic dialysis patients. Am J Kidney Dis. 1996;27:394\u2013401.","journal-title":"Am J Kidney Dis"},{"key":"2076_CR3","doi-asserted-by":"publisher","first-page":"2513","DOI":"10.1093\/ndt\/gfl257","volume":"21","author":"M Noordzij","year":"2006","unstructured":"Noordzij M, Korevaar JC, Bos WJ, Boeschoten EW, Dekker FW, Bossuyt PM, et al. Mineral metabolism and cardiovascular morbidity and mortality risk: peritoneal dialysis patients compared with haemodialysis patients. Nephrol Dial Transplant. 2006;21:2513\u201320.","journal-title":"Nephrol Dial Transplant"},{"key":"2076_CR4","doi-asserted-by":"publisher","first-page":"372","DOI":"10.4070\/kcj.2015.45.5.372","volume":"45","author":"OM G\u00fcrel","year":"2015","unstructured":"G\u00fcrel OM, Demircelik MB, Bilgic MA, Yilmaz H, Yilmaz OC, Cakmak M, et al. Association between red blood cell distribution width and coronary artery calcification in patients undergoing 64-multidetector computed tomography. Korean Circ J. 2015;45:372\u20137.","journal-title":"Korean Circ J"},{"key":"2076_CR5","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1111\/hdi.12040","volume":"17","author":"K Turkmen","year":"2013","unstructured":"Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A, et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013;17:391\u20136.","journal-title":"Hemodial Int"},{"key":"2076_CR6","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.1016\/j.athoracsur.2019.08.042","volume":"109","author":"F Mourad","year":"2020","unstructured":"Mourad F, Cleve N, Nowak J, Wendt D, Sander A, Demircioglu E, et al. Long-term single-center outcomes of patients with chronic renal dialysis undergoing cardiac surgery. Ann Thorac Surg. 2020;109:1442\u20138.","journal-title":"Ann Thorac Surg"},{"key":"2076_CR7","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s11748-008-0372-2","volume":"57","author":"M Yamamura","year":"2009","unstructured":"Yamamura M, Mitsuno M, Tanaka H, Kobayashi Y, Ryomoto M, Nishi H, et al. Risk factors for open heart surgery in hemodialysis patients. Gen Thorac Cardiovasc Surg. 2009;57:235\u20138.","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"2076_CR8","doi-asserted-by":"publisher","first-page":"679","DOI":"10.4009\/jsdt.52.679","volume":"52","author":"T Nitta","year":"2019","unstructured":"Nitta T, Masakin S, Hanafusa N, Goto S, Abe M, Nakai S, et al. 2018 Current status of chronic dialysis therapy in Japan (as of December 31, 2018). J Japan Soc Dial Ther. 2019;52:679\u2013754. (Japanese).","journal-title":"J Japan Soc Dial Ther"},{"key":"2076_CR9","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1093\/ndt\/12.4.718","volume":"12","author":"N Joki","year":"1997","unstructured":"Joki N, Hase H, Nakamura R, Yamaguchi T. Onset of coronary artery disease prior to initiation of haemodialysis in patients with end-stage renal disease. Nephrol Dial Transplant. 1997;12:718\u201323.","journal-title":"Nephrol Dial Transplant"},{"key":"2076_CR10","doi-asserted-by":"publisher","first-page":"563","DOI":"10.7326\/0003-4819-137-7-200210010-00007","volume":"137","author":"RS Wright","year":"2002","unstructured":"Wright RS, Reeder GS, Herzog GC, Albright RC, Williams BA, Dvorak DL, et al. Acute myocardial infarction and renal dysfunction: a high-risk combination. Ann Intern Med. 2002;137:563\u201370.","journal-title":"Ann Intern Med"},{"key":"2076_CR11","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1159\/000452310","volume":"189","author":"T Shigematsu","year":"2017","unstructured":"Shigematsu T, Sonou T, Ohya M, Yokoyama K, Yoshida H, Yokoo T, et al. Preventive strategies for vascular calcification in patients with chronic kidney disease. Contrib Nephrol. 2017;189:169\u201377.","journal-title":"Contrib Nephrol"},{"key":"2076_CR12","doi-asserted-by":"publisher","first-page":"51","DOI":"10.4103\/1319-2442.198127","volume":"28","author":"TZ El Baz","year":"2017","unstructured":"El Baz TZ, Khamis OA, Ahmed Gheith OA, Abd Ellateif SS, Abdallah AM, Abd El Aal HC. Relation of fibroblast growth factor-23 and cardiovascular calcification in end-stage kidney disease patients on regular hemodialysis. Saudi J Kidney Dis Transpl. 2017;28:51\u201360.","journal-title":"Saudi J Kidney Dis Transpl"},{"key":"2076_CR13","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1161\/01.CIR.0000136582.33493.CC","volume":"110","author":"DM Herrington","year":"2004","unstructured":"Herrington DM, Brown WV, Mosca L, Davis W, Eggleston B, Hundley WG, et al. Relationship between arterial stiffness and subclinical aortic atherosclerosis. Circulation. 2004;110:432\u20137.","journal-title":"Circulation"},{"key":"2076_CR14","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1177\/193229680700100217","volume":"1","author":"B Wilhelm","year":"2007","unstructured":"Wilhelm B, Klein J, Friedrich C, Forst S, Pf\u00fctzner A, Kann PH, et al. Increased arterial augmentation and augmentation index as surrogate parameters for arteriosclerosis in subjects with diabetes mellitus and nondiabetic subjects with cardiovascular disease. J Diabetes Sci Technol. 2007;1:260\u20133.","journal-title":"J Diabetes Sci Technol"},{"key":"2076_CR15","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1111\/j.1523-1755.2004.00530.x","volume":"65","author":"C Zoccali","year":"2004","unstructured":"Zoccali C, Benedetto FA, Mallamaci F, Stancanelli B, Cataliotti A, Malatino LS, et al. Left ventricular mass monitoring in the follow-up of dialysis patients: Prognostic value of left ventricular hypertrophy progression. Kidney Int. 2004;65:1492\u201398.","journal-title":"Kidney Int"},{"key":"2076_CR16","first-page":"1671","volume":"83","author":"G Pochmalicki","year":"1990","unstructured":"Pochmalicki G, Jan F, Fouchard I, Teiger F, Buisoon C, Benmaadi, et al. Frequency of painless myocardial ischemia during hemodialysis in 50 patients with chronic kidney failure. Arch Mal Coeur Vaiss. 1990;83:1671\u20135.","journal-title":"Arch Mal Coeur Vaiss"},{"key":"2076_CR17","doi-asserted-by":"publisher","first-page":"79","DOI":"10.3400\/avd.ra.17-00024","volume":"10","author":"D Hori","year":"2017","unstructured":"Hori D, Yamaguchi A, Adachi H. Coronary artery bypass surgery in end-stage renal disease patients. Ann Vasc Dis. 2017;10:79\u201387.","journal-title":"Ann Vasc Dis"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-021-02076-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-021-02076-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-021-02076-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T11:10:20Z","timestamp":1622718620000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-021-02076-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,3]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2076"],"URL":"https:\/\/doi.org\/10.1186\/s12872-021-02076-5","relation":{},"ISSN":["1471-2261"],"issn-type":[{"type":"electronic","value":"1471-2261"}],"subject":[],"published":{"date-parts":[[2021,6,3]]},"assertion":[{"value":"23 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Both patients in the presented cases were satisfied with explanations of their treatment before surgery and the postoperative course and test results.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patients\u2019 perspectives"}},{"value":"Written consent was obtained from the patients for the publication of these case reports. The Clinical Ethics Committee of Juntendo University Hospital approved this study (JHS20-019), which was conducted in accordance with the principles of the Helsinki Declaration.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent was obtained from the patients for the publication of their personal information in this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"271"}}