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 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.

Arterial Pulse Wave Velocity and Peritoneal Transport Characteristics Independently Predict Hospitalization in Chinese Peritoneal Dialysis Patients

2010 ◽  
Vol 30 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Ni Gao ◽  
Bonnie Ching-Ha Kwan ◽  
Kai-Ming Chow ◽  
Kwok-Yi Chung ◽  
Wing-Fai Pang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Fluid Overload ◽  
Technique Survival ◽  
Cardiothoracic Ratio ◽  
Peritoneal Transport ◽  
Duration Of Hospitalization

ObjectiveCardiovascular disease (CVD) is the most common cause of mortality in chronic peritoneal dialysis (PD) patients. Increased arterial stiffness may be related to a high peritoneal permeability resulting in fluid overload in PD patients. We studied the relations between arterial stiffness, peritoneal transport, and radiographic parameters of systemic fluid overload in a cohort of Chinese PD patients.DesignProspective cohort study.SettingUniversity referral center.PatientsWe studied 107 PD patients. Vascular pedicle width and cardiothoracic ratio were measured from a plain postero-anterior chest radiograph. Pulse wave velocity (PWV) was determined at carotid–femoral (C-F) and carotid–radial sites. Peritoneal transport was determined by the dialysate-to-plasma ratio (D/P) of creatinine at 4 hours of dwell. Patients were followed for 9.4 ± 4.6 months.Outcome MeasuresDuration of hospitalization; actuarial and technique survival.ResultsThere were no relationships between radiographic measures, arterial PWV, and D/P creatinine. However, both C-F PWV and D/P creatinine were independent predictors of the number of hospitalizations for CVD. None of the parameters correlated with mortality in this study.ConclusionsThere were no relationships between radiological parameters of fluid overload, peritoneal transport characteristics, and arterial PWV. Both C-F PWV and D/P creatinine were independent predictors of the number of hospitalizations for CVD. Our result suggests that arterial stiffness and high peritoneal transport each contribute to the development of CVD in this group of patients.

Bone Mineral Density, Vascular Calcifications, and Arterial Stiffness in Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (6) ◽  
pp. 668-672 ◽  
Author(s):  
Teresa Adragao ◽  
Patrícia Branco ◽  
Rita Birne ◽  
José Dias Curto ◽  
Edgar de Almeida ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Dialysis Patients ◽  
Mineral Density ◽  
Vascular Calcifications ◽  
Calcification Score

The objective of this study was to evaluate the correlation of bone mineral density (BMD), evaluated by DXA, with vascular calcifications, arterial stiffness, and vascular disease in patients on peritoneal dialysis. Vascular calcifications were evaluated by vascular calcification score on plain x ray, and arterial stiffness was measured by pulse wave velocity using the Complior device (Artech Medical, Pantin, France). Adjusting for multiple factors, lower BMD at the femoral neck, but not at the lumbar spine, was associated with higher pulse wave velocity ( p = 0.037), higher vascular calcification score ( p = 0.013), and peripheral artery disease ( p = 0.006). These data reinforce the hypothesis of the existence of a link between bone disease and cardiovascular disease in dialysis patients.

scholarly journals Risk factors associated with brachial–ankle pulse wave velocity among peritoneal dialysis patients in Macao

2012 ◽  
Vol 13 (1) ◽  
Author(s):  
Ding-Wei Kuang ◽  
Chiu-Leong Li ◽  
Un-I Kuok ◽  
Kin Cheung ◽  
Weng-In Lio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Dialysis Patients ◽  
Factors Associated

scholarly journals Factors associated with arterial stiffness in children aged 9-10 years

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Milena Santos Batista ◽  
José Geraldo Mill ◽  
Taisa Sabrina Silva Pereira ◽  
Carolina Dadalto Rocha Fernandes ◽  
Maria del Carmen Bisi Molina
Keyword(s):  
Blood Pressure ◽  
Linear Regression ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Multiple Linear Regression ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Southeastern Brazil ◽  
Convenience Sample ◽  
Factors Associated

OBJECTIVE To analyze the factors associated with stiffness of the great arteries in prepubertal children.METHODS This study with convenience sample of 231 schoolchildren aged 9-10 years enrolled in public and private schools in Vitória, ES, Southeastern Brazil, in 2010-2011. Anthropometric and hemodynamic data, blood pressure, and pulse wave velocity in the carotid-femoral segment were obtained. Data on current and previous health conditions were obtained by questionnaire and notes on the child’s health card. Multiple linear regression was applied to identify the partial and total contribution of the factors in determining the pulse wave velocity values.RESULTS Among the students, 50.2% were female and 55.4% were 10 years old. Among those classified in the last tertile of pulse wave velocity, 60.0% were overweight, with higher mean blood pressure, waist circumference, and waist-to-height ratio. Birth weight was not associated with pulse wave velocity. After multiple linear regression analysis, body mass index (BMI) and diastolic blood pressure remained in the model.CONCLUSIONS BMI was the most important factor in determining arterial stiffness in children aged 9-10 years.

scholarly journals P1567 Left atrial function - association with left ventriculoarterial function in hypertensive patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N Georgieva ◽  
A Borizanova - Petkova ◽  
E Kinova ◽  
A Goudev
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Left Atrium ◽  
Wave Velocity ◽  
Left Atrial ◽  
Pulse Wave ◽  
Systolic Pressure ◽  
Healthy Controls ◽  
Hypertensive Patients ◽  
Moderate Positive Correlation

Abstract BACKGROUND Vascular stiffness and left atrial volume index (LAVI) are predictors of cardiovascular complications in hypertensive patients. The correlation of left atrium (LA) with left ventricle (LV) – arterial functional changes has not been well established. PURPOSE To investigate the relationship between LA remodeling and ventriculoarterial function. METHODS We studied 70 consecutive middle-aged patients (54 ± 13 years), separated in two groups: 55 with mild to moderate hypertension and duration up to 5 years and 15 healthy controls. All parameters for arterial stiffness – 24-hour central systolic pressure (cSys24h), central pulse pressure (cPP24h), augmentation index 24h (Aix24h) and 24-hour pulse wave velocity (PWV24h) were measured non–invasively with oscillometric method by Mobil-O-graph PWA. All patients underwent standard two-dimentional echocardiography with Spackle tracking analysis for LA and LV global longitudinal strain (GLS). RESULTS Statistically significant differences in parameters of vascular stiffness were found in patients with hypertension in comparison with healthy controls: cSys24h (116.64 ± 10.52 vs. 108.4 ± 6.19 mm Hg, p &lt; 0.001), cPP24h (47.64 ± 9.43 vs. 40.4 ± 4.98 mmHg, p &lt; 0.001), PWV24h (8.59 ± 1.49 vs. 6.29 ± 0.91 m/s, p &lt; 0.0001). Patients with hypertension have higher LV filling pressures: E/e ratio (9.62 ± 3.13 vs. 7.62 ± 1.58, p &lt; 0.006), higher velocities of A–wave transmitral blood flow (85.15 ± 16.88 vs. 64.57 ± 13.76 cm/s, p &lt; 0.0001), dilated LA (LAVI: 33.78 ± 10.68 vs. 24.96 ± 4.89 ml/m², p &lt; 0.001) and reduced LA GLS (29.34 ± 3.45 vs. 41.33 ± 4.37%, p &lt; 0.0001) in comparison to control group. There were no statistically significant differences in Aix24h and cardiac output between the two groups. There is moderate positive correlation between LAVI with cPP24h (r = 0.491, p &lt; 0.0001) and cSys24h (r = 0.366, p &lt; 0.004). We found moderate positive correlation between LAVI and LV mass index (r = 0.386, p &lt; 0.002). PWV24h correlated moderately and positively with LAVI (r = 0.404, p&lt; 0.0001), and negatively with LA GLS (r = -0.471, p &lt; 0.0001). CONCLUSION: LA remodeling is determined by the high 24-hour values of non-invasively measured central systolic pressure and pulse wave velocity. The parameters of arterial stiffness - cSys24h, cPP24h correlate positively with LA. PWV24h correlates negatively with reservoir strain of the left atrium. Using the method in clinical practice can improve risk stratification and therapeutic management. Further investigations are needed for prognostic and therapeutic value of LA remodeling.

scholarly journals AB0406 ASSOCIATION OF ENDOTHELIN-1 WITH PULSE WAVE VELOCITY IN SYSTEMIC SCLEROSIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1231.2-1232
Author(s):  
A. Alvarez de Cienfuegos ◽  
L. Cantero-Nieto ◽  
J. A. García-Gómez ◽  
J. L. Callejas-Rubio ◽  
J. Martin Ibanez ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Connective Tissue ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Serum Levels ◽  
Healthy Controls ◽  
Endothelin 1 ◽  
Female Patients

Background:Systemic sclerosis (SSc) is a multisystemic disease featured by vascular and immunological disorders along with an excessive accumulation of the components of the connective tissue that cause cutaneous sclerosis and fibrosis of different organs. The occurrence of endothelial dysfunction together with fibrosis indicates that endothelial cell-derived factors, such as endothelin-1 (ET-1), may have an important role in the pathogenesis of SSc. The upregulation of ET-1 activates inflammatory cells and leads to nitric oxide synthase inhibition associated with arterial stiffness.Objectives:The purpose of this study was to evaluate ET-1 serum levels in women with systemic sclerosis (SSc) compared with healthy controls and to examine possible associations between ET-1 and markers of arterial stiffness.Methods:This cross-sectional study was performed in San Cecilio Hospital, Granada (Spain) from November 2017 to May 2019. Sixty-two women with SSc and 62 age and sex matched healthy controls were enrolled in this study. Pulse Wave Velocity (PWV) was measured non-invasively along the carotid–femoral arterial segment. Serum ET-1 was analysed using indirect enzyme-linked immunosorbent assay (ELISA).Results:A total of 62 female patients were included in our study, with a mean (SD) age of 53 ± 10 years. The majority were Caucasian (90.5%). The mean disease duration was 8.8 ± 6.9 years. Forty-four (70.9%) patients had a limited form of the disease and 18 (29.1%) had a diffuse form.There was a significant difference in ET-1 serum levels between SSc female patients and healthy controls (28.4 ± 10.6 vs. 21.1 ± 11.7 pg/ml, p = 0.001). Serum levels of ET-1 were positively associated with PWV (r = 0.26, p < 0.05), within the study group. In addition, in the linear regression model, higher ET-1 concentrations were associated with higher PWV [β = 0.03 95% CI (0.001, 0.060); p < 0.05].Conclusion:This study shows that ET-1 serum levels are associated with PWV in women with SSc. Therefore, drugs that block ET-1 may be effective in reducing large artery stiffness in women with SSc, and thus cardiovascular risk.References:[1]LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA Jr, et al. Scleroderma (systemic sclerosis): classification, bubsets and pathogenesis. J Rheumatol 1988; 15(2):202-205.[2]Shi-Wen X, Denton CP, Dashwood MR, Holmes AM, Bou-Gharios G, Pearson JD, et al. Fibroblast matrix gene expression and connective tissue remodeling: role of endothelin-1. J Invest Dermatol 2001; 116(3):417–425.[3]Heintz B, Dörr R, Gillessen T, Walkenhorst F, Krebs W, Hanrath P, et al. Do arterial endothelin 1 levels affect local arterial stiffness?. Am Heart J 1993; 126 (4): 987–989.[4]McEniery CM, Qasem A, Schmitt M, Avolio AP, Cockcroft JR, Wilkinson IB. Endothelin-1 regulates arterial pulse wave velocity in vivo. J Am Coll Cardiol 2003; 42 (11): 1975–1981.Disclosure of Interests:None declared

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.

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