Volume 68, Issue 4, Pages 308-315 (October 2016) Serum phosphate is an independent predictor of the total aortic calcification volume in non-hemodialysis patients undergoing cardiovascular surgery  Mitsuo Kinugasa, MD, PhD, Shumpei Mori, MD, Tomofumi Takaya, MD, PhD, Tatsuro Ito, MD, PhD, Hidekazu Tanaka, MD, PhD, FJCC, Seimi Satomi-Kobayashi, MD, PhD, Sei Fujiwara, MD, PhD, Tatsuya Nishii, MD, PhD, Atsushi K. Kono, MD, PhD, Yutaka Okita, MD, PhD, Ken-ichi Hirata, MD, PhD  Journal of Cardiology  Volume 68, Issue 4, Pages 308-315 (October 2016) DOI: 10.1016/j.jjcc.2015.10.005 Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 1 Volume-rendered total aortic calcification image that was fused with a body trunk image. Aortic calcification volume (sky-blue) was extracted using a volume-rendering method and fused with a volume-rendered whole body trunk image. The transparency of the body trunk was increased (A–C) to emphasize the location of the total aortic calcification. The total aortic calcification volume (≥130HU) was quantified as 18.74mL (C). The total aortic calcification was divided into thoracic (yellow) and abdominal (red) aortic calcifications (D). The thoracic and abdominal aortic calcification volumes were quantified as 11.40 and 7.34mL, respectively. Journal of Cardiology 2016 68, 308-315DOI: (10.1016/j.jjcc.2015.10.005) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 2 Relationship between the serum phosphate and adjusted serum calcium levels and each total aortic calcification volume index (AC-VI) quartile, calculated from an ordinary logistic regression model. The increase in serum phosphate level was significantly correlated with an increased probability of having a total AC-VI in quartile 4 and reduced probability of having a total AC-VI in quartile 1 by ordinal logistic regression analysis (A), whereas the adjusted serum calcium level did not show a significant correlation (B). Patients were equally divided into four groups by quartile values of total AC-VI. Quartile 4 included the patients in the highest total AC-VI category. Journal of Cardiology 2016 68, 308-315DOI: (10.1016/j.jjcc.2015.10.005) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 3 Relationship between the serum phosphate and adjusted serum calcium levels and each thoracic aortic calcification volume index (AC-VI) quartile, calculated from an ordinary logistic regression model. The increase in serum phosphate level was significantly correlated with an increased probability of having a thoracic AC-VI in quartile 4 and reduced probability of having a thoracic AC-VI in quartile 1 by ordinal logistic regression analysis (A), whereas the adjusted serum calcium level did not show a significant correlation (B). Patients were equally divided into four groups by quartile values of thoracic AC-VI. Quartile 4 included the patients in the highest thoracic AC-VI category. Journal of Cardiology 2016 68, 308-315DOI: (10.1016/j.jjcc.2015.10.005) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 4 Relationship between the serum phosphate and adjusted serum calcium levels and each abdominal aortic calcification volume index (AC-VI) quartile, calculated from an ordinary logistic regression model. The increase in serum phosphate level was significantly correlated with an increased probability of having an abdominal AC-VI in quartile 4 and reduced probability of having an abdominal AC-VI in quartile 1 by ordinal logistic regression analysis (A), whereas the adjusted serum calcium level did not show a significant correlation (B). Patients were equally divided into four groups by quartile values of abdominal AC-VI. Quartile 4 included the patients in the highest abdominal AC-VI category. Journal of Cardiology 2016 68, 308-315DOI: (10.1016/j.jjcc.2015.10.005) Copyright © 2015 Japanese College of Cardiology Terms and Conditions