Changes in aortic pulse wave velocity in peritoneal dialysis do not mirror changes in extracellular water measured by bioimpedance

2020 ◽  
pp. 039139882093110
Author(s):  
Kamonwan Tangvoraphonkchai ◽  
Andrew Davenport
Keyword(s):  
Peritoneal Dialysis ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity ◽  
Confidence Limits ◽  
Extracellular Water ◽  
C Reactive Protein ◽  
Dialysis Patients ◽  
Reactive Protein

Background: Pulse wave velocity is a measurement of arterial stiffness and associated with increased cardiovascular mortality. Previous reports in peritoneal dialysis have linked increased pulse wave velocity with an expansion in extracellular water. As cardiovascular mortality is increased in peritoneal dialysis patient, we wished to determine whether changes in pulse wave velocity mirrored changes in extracellular water. Methods: We repeated aortic pulse wave velocity and bioimpedance-derived extracellular water measurements in peritoneal dialysis patients attending for assessment of peritoneal membrane function. Results: Sixty-six patients, 41 males (62.1%), mean age of 66.2 ± 13.9 years, median duration of peritoneal dialysis treatment (14.3 (3.1–31.9) months) had repeated measurement 6.4 (5.8–10.2) months apart, with no significant change in aortic pulse wave velocity (10.1 ± 3.2 to 9.9 ± 2.8 m/s). In univariate analysis, the initial aortic pulse wave velocity was associated with extracellular water (r = 0.26, p = 0.034) and serum N-terminal pro brain-type natriuretic peptide (r = 0.25, p = 0.04), and on follow-up, aortic pulse wave velocity with N-terminal pro brain-type natriuretic peptide (r = 0.31, p = 0.01). Aortic pulse wave velocity increased in 50% of patients, and these patients had greater serum C-reactive protein 3(2–10) versus 2(1–4) mg/L, and ferritin (778(444–1099) versus 585(313–811), p < 0.05), but there were no differences in either absolute or adjusted extracellular water. Both log C-reactive protein (odds ratio 4.7 (95% confidence limits 1.3–17.1), p = 0.019) and prescription of calcium channel blockers (odds ratio 4.9 (95% confidence limits 1.2–19.1), p = 0.024) were independently associated with an increase in aortic pulse wave velocity. Conclusion: We did not find an independent association between a change in aortic pulse wave velocity and extracellular water, suggesting that changes in aortic stiffness in peritoneal dialysis patients are more complex than simply following changes in extracellular water.

scholarly journals Association Between C-Reactive Protein Genotype, Circulating Levels, and Aortic Pulse Wave Velocity

Hypertension ◽  
2009 ◽  
Vol 53 (2) ◽  
pp. 150-157 ◽  
Author(s):  
Wiebke Schumacher ◽  
John Cockcroft ◽  
Nicholas J. Timpson ◽  
Carmel M. McEniery ◽  
John Gallacher ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Circulating Levels ◽  
Protein Genotype

scholarly journals Aortic Pulse Wave Velocity in Peritoneal Dialysis Patients Is Not Simply Associated with Extracellular Water Expansion

2019 ◽  
Vol 44 (6) ◽  
pp. 1423-1431 ◽  
Author(s):  
Kamonwan Tangvoraphonkchai ◽  
Andrew Davenport
Keyword(s):  
Peritoneal Dialysis ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity ◽  
Extracellular Water ◽  
Peritoneal Membrane ◽  
Β Blocker ◽  
Independent Association ◽  
Total Body

Background: Cardiac death is increased in peritoneal dialysis (PD) patients. Pulse wave velocity (PWV) is a measurement of arterial stiffness, and previous reports linked PWV to increased extracellular water (ECW). As cyclers and icodextrin are increasingly used, we wished to determine whether this association between PWV and ECW remains. Methods: We measured aortic PWV (aPWV) and bioimpedance (InBody, Seoul, South Korea) in consecutive PD patients attending for peritoneal membrane testing. Results: 189 patients were included, 62.4% male, mean age 63.1 ± 15.2 years, 45.3% diabetic, median dialysis duration 12.3 (6.5–25.1) months, 71.4% using cyclers, weight 73.0 ± 16.1 kg, systolic blood pressure 142 ± 21 mm Hg, aPWV 10.4 ± 5.1 m/s. aPWV was associated with pulse pressure (r = 0.26, p = 0.001), Davies comorbidity score (r = 0.18, p = 0.013), and N-terminal pro-brain-type natriuretic peptide (NTproBNP; r = 0.18, p = 0.011). Patients with aPWV ≥10 m/s were older (65.9 ± 13.6 vs. 60.1 ± 16.3 years, p < 0.01) with a higher ECW-to-total body water ratio (0.400 ± 0.012 vs. 0.396 ± 0.013, p < 0.05), but ECW/height was not different (8.52 ± 2.32 vs. 8.75 ± 1.78 L/m), as was NTproBNP (2,472 [788–5,422] vs. 1,234 [410–6,230] ng/L). On multivariable testing, aPWV was positively associated with β-blocker prescription (standardised β coefficient [Stβ] 0.3, 95% confidence limits [95% CL] 0.7–2.6, p = 0.001) and negatively with icodextrin prescription (Stβ 0.19, 95% CL –0.2 to –2.1, p = 0.04). Conclusions: Compared to previous studies, we did not find an independent association between aPWV and ECW and estimates of ECW excess, using the InBody bioimpedance device, suggesting that vascular stiffness in PD patients is more complex than simple ECW volume expansion in PD patients.

The association between cumulative C-reactive protein and brachial–ankle pulse wave velocity

2019 ◽  
Vol 32 (5) ◽  
pp. 789-796 ◽  
Author(s):  
Lixia Sun ◽  
Chunhong Ning ◽  
Jiqiang Liu ◽  
Tao Yao ◽  
Li Zhang ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Aortic-Brachial Stiffness Mismatch and Mortality in Peritoneal Dialysis Patients

2019 ◽  
Vol 44 (1) ◽  
pp. 123-132 ◽  
Author(s):  
WenHan Bao ◽  
FangYu Wang ◽  
Wen Tang
Keyword(s):  
Regression Analysis ◽  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Cox Regression ◽  
Dialysis Patients ◽  
Cox Regression Analysis ◽  
Cvd Mortality

Background/Aims: Possible predictive value of aortic-brachial arterial stiffness mismatch assessed by pulse wave velocity PWV ratio in peritoneal dialysis patients’ outcomes need to be further elucidated. The aim of this study is to investigate the predictor value of PWV ratio on peritoneal dialysis (PD) patients’ outcomes in China. Methods: In this longitudinal cohort study, patients who started PD during September 20, 2005, to February 05, 2008, were included. All the patients were followed until January 31, 2018. Aortic-brachial arterial stiffness mismatch was assessed using carotid-femoral pulse wave velocity divided by carotid-radial pulse wave velocity (PWV ratio). Results: A total of 181 incident PD patients were included. The median survival of patients in PWV ratio above median group (4.03 years, 95% CI 4.64-7.99 years) was shorter than that of PWV ratio below median group (10.43 years, 95% CI 9.74-11.12 years, p< 0.001). The cardiovascular mortality rate in PWV ratio above median group were significantly higher than that of PWV below median group (log rank test, p< 0.001). Univariate Cox regression analysis showed that both PWV ratio (HR 2.42, 95% CI 1.80-3.25, p< 0.001) and CF-PWV (HR 1.27, 95% CI 1.16-1.38, p< 0.001) were associated with high patients’ all-cause mortality. Multivariable Cox regression analysis showed that the PWV ratio was a strong and significantly predictor of cardiovascular mortality (HR 2.08 95% CI 1.16-3.71, p=0.014) after adjusting for coronary heart disease history (HR 2.39, 95% CI 1.20-4.76, p=0.013), diabetes mellitus history (HR 2.84, 95% CI 1.51-5.33, p=0.001). However, the CF-PWV was failed to be included as a significant predictor for both all-cause and CVD mortality in the multivariable Cox regression model. Conclusion: Aortic-brachial arterial stiffness mismatch as assessed by PWV ratio, a new arteries stiffness risk parameter, is a significant prognostic indicator of CVD mortality in PD patients. We demonstrated that the discriminative power of the PWV ratio for both all-cause and CVD mortality was better than that CF-PWV.

Factors associated with increased pulse wave velocity in peritoneal dialysis patients

Open Medicine ◽  
2010 ◽  
Vol 5 (3) ◽  
pp. 381-386 ◽  
Author(s):  
Paweł Stróżecki ◽  
Rafał Donderski ◽  
Magdalena Grajewska ◽  
Elżbieta Marcinkowska ◽  
Michał Kozłowski ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Dialysis Patients ◽  
Factors Associated ◽  
Peritoneal Transport

AbstractElevated pulse wave velocity (PWV) reflects increased arterial stiffness. Several studies have investigated PWV in peritoneal dialysis (PD) patients, but direct comparisons with healthy controls were not done. The potential influence of peritoneal transport characteristics on arterial stiffness in PD patients was suggested in recent studies. The aims of this study were to compare PWV in PD patients and healthy volunteers, and to investigate factors associated with increased PWV. The carotid-femoral PWV was measured in 28 PD patients and 28 healthy controls, matched for age and gender. A peritoneal equilibration test (PET) was performed in all PD patients. Based on the PET, patients were classified as: high transporters (H) (n=8), high-average (HA) (n=12), low-average (LA) (n=6), and low transporters (L) (n=2). Six of the PD patients were diabetic. PWV was significantly higher in the PD patients than in the controls (9,9±2,4 vs. 8,0±0,9; p=0,0004). In the PD group, PWV was higher in H/HA than in L/LA patients (10,4 ± 2,5 vs. 8,6 ± 1,0; p=0,008), but all the diabetic patients were in the H/HA group. PWV was significantly higher in diabetic than in non-diabetic PD patients (12,8 ± 2,0 vs. 9,1 ± 1,7; p=0,004). In the PD patients, significant positive correlations were found between PWV and: age, pulse pressure, Kt/V, and duration of PD therapy. In conclusion, the carotid-femoral PWV is elevated in peritoneal dialysis patients. Increased PWV in PD patients is associated with age, diabetic status, and longer duration of PD therapy, but not with this type of peritoneal transport.

scholarly journals Central arterial stiffness is associated with systemic inflammation among Asians with type 2 diabetes

2016 ◽  
Vol 13 (4) ◽  
pp. 303-306 ◽  
Author(s):  
Xiao Zhang ◽  
Jian Jun Liu ◽  
Chee Fang Sum ◽  
Yeoh Lee Ying ◽  
Subramaniam Tavintharan ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
High Sensitivity ◽  
Soluble Receptor ◽  
C Reactive Protein ◽  
Advanced Glycation ◽  
Reactive Protein ◽  
Glycation End Products

Objective: To examine the relationship between inflammation and central arterial stiffness in a type 2 diabetes Asian cohort. Method: Central arterial stiffness was estimated by carotid-femoral pulse wave velocity and augmentation index. Linear regression model was used to evaluate the association of high-sensitivity C-reactive protein and soluble receptor for advanced glycation end products with pulse wave velocity and augmentation index. High-sensitivity C-reactive protein was analysed as a continuous variable and categories (<1, 1–3, and >3 mg/L). Results: There is no association between high-sensitivity C-reactive protein and pulse wave velocity. Augmentation index increased with high-sensitivity C-reactive protein as a continuous variable ( β = 0.328, p = 0.049) and categories ( β = 1.474, p = 0.008 for high-sensitivity C-reactive protein: 1–3 mg/L and β = 1.323, p = 0.019 for high-sensitivity C-reactive protein: >3 mg/L) after multivariable adjustment. No association was observed between augmentation index and soluble receptor for advanced glycation end products. Each unit increase in natural log–transformed soluble receptor for advanced glycation end products was associated with 0.328 m/s decrease in pulse wave velocity after multivariable adjustment ( p = 0.007). Conclusion: Elevated high-sensitivity C-reactive protein and decreased soluble receptor for advanced glycation end products are associated with augmentation index and pulse wave velocity, respectively, suggesting the potential role of systemic inflammation in the pathogenesis of central arterial stiffness in type 2 diabetes.

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