P4.4 DOPPLER INDEXES OF LEFT VENTRICULAR SYSTOLIC AND DIASTOLIC FLOWS AND CENTRAL PULSE PRESSURE IN RELATION TO RENAL RESISTIVE INDEX IN A GENERAL POPULATION

2014 ◽  
Vol 8 (4) ◽  
pp. 140
Author(s):  
N. Cauwenberghs ◽  
J. Knez ◽  
L. Thijs ◽  
Y.-P. Liu ◽  
Y.-M. Gu ◽  
...  
Keyword(s):  
General Population ◽  
Pulse Pressure ◽  
Resistive Index ◽  
Left Ventricular ◽  
Renal Resistive Index ◽  
Central Pulse Pressure

scholarly journals Doppler Indexes of Left Ventricular Systolic and Diastolic Flow and Central Pulse Pressure in Relation to Renal Resistive Index

2014 ◽  
Vol 28 (4) ◽  
pp. 535-545 ◽  
Author(s):  
Tatiana Kuznetsova ◽  
Nicholas Cauwenberghs ◽  
Judita Knez ◽  
Lutgarde Thijs ◽  
Yan-Ping Liu ◽  
...  
Keyword(s):  
Pulse Pressure ◽  
Resistive Index ◽  
Left Ventricular ◽  
Renal Resistive Index ◽  
Diastolic Flow ◽  
Central Pulse Pressure

The association between renal resistive index and premature mortality after kidney transplantation is modified by pre-transplant diabetes status: a cohort study

2019 ◽  
Vol 35 (9) ◽  
pp. 1577-1584
Author(s):  
Jean-Baptiste de Freminville ◽  
Louis-Marie Vernier ◽  
Jérome Roumy ◽  
Frédéric Patat ◽  
Philippe Gatault ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Pulse Pressure ◽  
Predictive Value ◽  
Resistive Index ◽  
Renal Resistive Index ◽  
Diabetic Patients ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Diabetes Status

Abstract Background Renal resistive index (RI) predicts mortality in renal transplant recipients, but we do not know whether this is true in diabetic patients. The objective of this study was to analyse the long-term predictive value of RI for death with a functioning graft (DWFG) in renal transplant recipients with or without pre-transplant diabetes. Methods We conducted a retrospective study in 1800 renal transplant recipients between 1985 and 2017 who were followed for up to 30 years (total observation period: 14 202 patient years). Donor and recipient characteristics at time of transplantation and at 3 months were reviewed. The long-term predictive value of RI for DWFG and the age–RI and arterial pressure–RI relationships were assessed. Results A total of 284/1800 (15.7%) patients had diabetes mellitus before transplantation. RI was <0.75 in 1327/1800 patients (73.7%). High RI was associated with a higher risk of DWFG in non-diabetic patients [hazard ratio (HR) = 3.39, 95% confidence interval 2.50–4.61; P < 0.001], but not in patients with pre-transplant diabetes (HR = 1.25, 0.70–2.19; P = 0.39), even after multiple adjustments. There was no interaction between diabetes and age. In contrast, there was an interaction between RI and pulse pressure. Conclusion Our study indicates that RI is not a predictor of DWFG in diabetic renal transplant recipients, in contrast to non-diabetic recipients. These findings could be due to a different age–RI or pulse pressure–RI relationship.

scholarly journals HbA1c is an Independent Determinant of Renal Vascular Resistance Estimated by Doppler Sonography in Non-Diabetic Hypertensive Patients

2008 ◽  
Vol 1 ◽  
pp. CMED.S936
Author(s):  
Ken-ichi Miyoshi ◽  
Takafumi Okura ◽  
Tomoaki Nagao ◽  
Masanori Jotoku ◽  
Daijiro Enomoto ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Essential Hypertension ◽  
Blood Glucose ◽  
Pulse Pressure ◽  
Blood Glucose Control ◽  
Resistive Index ◽  
Renal Resistive Index ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Hba1c Levels

Background Diabetic nephropathy is a progressive disease that leads to renal failure and end stage renal disease. A frequent and early manifestation of diabetic nephropathy is hyaline arteriolosclerosis. The noninvasive method for estimating the severity of arteriolosclerosis is measurement of the renal resistive index (RI). In this study, we determined whether or not normal blood glucose control, classified as an HbA1c < 5.8%, was a sufficiently low level to prevent arteriolosclerosis in patients with essential hypertension. Methods The study subjects were 93 patients with essential hypertension with HbA1c levels <5.8%. Patients with a history of medication for diabetes mellitus were excluded. Blood flow velocity of the renal interlobar arteries was assessed by a Doppler ultrasonography and the RI calculated. Results RI correlated positively with age, body mass index, pulse pressure, pulse rate and HbA1c, and negatively with diastolic blood pressure. A multivariate analysis identified age, pulse pressure and HbA1c as significant independent determinants of RI. Our data show that RI correlates with HbA1c independent of other variables, even in normoglycemic patients with HbA1c levels <5.8%. Conclusions The results of this cross-sectional study suggest that blood glucose levels should be kept as low as possible in order to prevent arteriolosclerosis in the kidney in hypertensive patients.

scholarly journals Central Pulse Pressure and Variability in Matrix Metalloproteinases Genes and Their Inhibitors in Patients With Ischemic Heart Disease

2014 ◽  
pp. S497-S507
Author(s):  
A. VAŠKŮ ◽  
J. BIENERTOVÁ-VAŠKŮ ◽  
J. PAŘENICA ◽  
M. PÁVKOVÁ GOLDBERGOVÁ ◽  
J. NOVÁK ◽  
...  
Keyword(s):  
Matrix Metalloproteinases ◽  
Genetic Variability ◽  
Pulse Pressure ◽  
Diastolic Pressure ◽  
Restriction Analysis ◽  
Left Ventricular ◽  
Individual Therapy ◽  
Age Related ◽  
Clinical Conditions ◽  
Central Pulse Pressure

Matrix metalloproteinases (MMPs) as well as their inhibitors (TIMPs) play a crucial role in controlling extracellular matrix turnover and have recently been associated with atherosclerosis, myocardial and vascular injury. Moreover, the genetic variability of MMP genes has been suggested to play an important role in vascular remodeling and age-related arterial stiffening. This study aims to describe associations of 14 selected polymorphisms in genes for MMPs and TIMPs with selected cardiovascular parameters (including central pulse pressure), clinical conditions and drug treatment profiles in 411 stable ischemic patients with preserved systolic function of the left ventricle. The genotyping of 14 single-nucleotide polymorphisms in 8 genes was carried out either using 5′ exonuclease (TaqMan®) reagents or by restriction analysis. Numerous associations of the investigated polymorphisms with systolic and diastolic blood pressure, maximum left ventricular end diastolic pressure and ejection fraction were observed. While some of the observed effects were found to be age-dependent, associations with clinical conditions (hypertension, diabetes mellitus, angina pectoris) were only observed in women and associations with four groups of drugs (statins, nitrates, calcium channel blockers, anti-aggregation drugs) were only observed in men. The results of this study indicate that the genetic variability of MMPs and TIMPs is an important factor which influences cardiovascular functions and may have important consequences for individual therapy customization in the future.

scholarly journals Impact of microaxillar mechanical left ventricular support on renal resistive index in patients with cardiogenic shock after myocardial infarction: a pilot trial to predict renal organ dysfunction in cardiogenic shock

2019 ◽  
Vol 9 (2) ◽  
pp. 158-163 ◽  
Author(s):  
Birgit Markus ◽  
Nikolaos Patsalis ◽  
Georgios Chatzis ◽  
Ulrich Luesebrink ◽  
Holger Ahrens ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Cardiogenic Shock ◽  
Diastolic Blood Pressure ◽  
Peak Systolic Velocity ◽  
Resistive Index ◽  
Left Ventricular ◽  
Renal Resistive Index ◽  
Mechanical Support ◽  
Ventricular Support

Objectives: To evaluate the effects of left ventricular support with the microaxial left ventricular pump using the Impella device on the renal resistive index assessed by Doppler ultrasonography in haemodynamically stable patients with cardiogenic shock following myocardial infarction. Methods: A non-randomised interventional single-centre study. Consecutive patients with cardiogenic shock supported with an Impella were included during May 2018 and October 2018. The renal resistive index determined as a quotient of (peak systolic velocity – end diastolic velocity)/ peak systolic velocity was obtained using Doppler ultrasound; invasive blood pressure was determined in radial artery simultaneously for safety reasons. Results: A total of 15 patients were measured. The renal resistive index was determined in both kidneys in 13 patients and for one kidney in two patients, respectively. The mean difference between right and left renal resistive index was 0.026 ± 0.023 ( P=0.72). When increasing the Impella microaxillar mechanical support by a mean of 0.44 L/min (±0.2 L/min), the renal resistive index decreased significantly from 0.66 ± 0.08 to 0.62 ± 0.06 ( P<0.001) consistently in all patients, whereas systolic or diastolic blood pressure remained unchanged. Conclusions: Microaxillar mechanical support by the Impella device in haemodynamically stable patients with cardiogenic shock led to a significant reduction of the renal resistive index without affecting systolic or diastolic blood pressure. This observation is consistent with the notion that Impella support may promote renal organ protection by enhancing renal perfusion.

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