Aortic pulse wave velocity predicts mortality in chronic kidney disease stages 2–4

Baumann, Marcus; Wassertheurer, Siegfried; Suttmann, Yana; Burkhardt, K; Heemann, Uwe

doi:10.1097/hjh.0000000000000113

Cited by 93 publications

(42 citation statements)

References 56 publications

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“…No association was shown between baseline aortic stiffness and GFR decline in a mixed model regression analysis [46]. The same observation was made by Baumann et al [51] in a cohort of 135 CKD patients (mean follow-up 42 months, mean eGFR 41.1 ml/min/1.73 m 2 ). On the other hand, in a prospective cohort (follow-up 1.5 years) of 120 patients (mean age 69 ± 12 years) at stages 3-4 CKD (baseline eGFR 32 ± 11 ml/min/1.73 m 2 ), aortic PWV was significantly associated with the gradient of reciprocal creatinine plot, monitoring change in eGFR.…”

Section: Impact Of Aortic Stiffness On Ckd Progressionsupporting

confidence: 56%

Arterial Stiffness and Chronic Kidney Disease

Garnier

Briet²

2015

Pulse

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Chronic kidney disease (CKD) is a major public health concern due to the high prevalence of associated cardiovascular (CV) disease. CV mortality is 10-30 times higher in end-stage renal disease patients than in the age-adjusted general population. The last 20 years have been marked by a huge effort in the characterization of the vascular remodeling process associated with CKD and its consequences on the renal, CV and general prognosis. By comparison with patients with normal renal function, with or without hypertension, an increase in large artery stiffness has been described in end-stage renal disease as well as in CKD stages 2-5. Most clinical studies are consistent with the observation that damage to large arteries may contribute to the high incidence of CV disease. By contrast, the impact of large artery stiffening and remodeling on CKD progression is still a matter of debate. Concomitant exposure to other CV risk factors, including diabetes, seems to play a major role in the association between aortic stiffness and estimated GFR. The conflicting results obtained from longitudinal studies designed to evaluate the impact of baseline aortic stiffness on GFR progression are detailed in the present review. Only pulse pressure, central and peripheral, is almost constantly associated with incident CKD and GFR decline. Kidney transplantation improves patients' CV prognosis, but its impact on arterial stiffness is still controversial. Donor age, living kidney donation and mean blood pressure appear to be the main determinants of improvement in aortic stiffness after kidney transplantation.

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Section: Impact Of Aortic Stiffness On Ckd Progressionsupporting

confidence: 56%

Arterial Stiffness and Chronic Kidney Disease

Garnier

Briet²

2015

Pulse

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“…Cheng et al 18 conducted a meta-analysis of six cohort studies and reported an increased risk of atrial fibrillation with 1°HB. There are two additional studies in our review, Perez et al 14 and Uhm et al 16 and both of these studies suggest an increased risk of atrial fibrillation with 1°HB. We build upon this review by including the other outcomes mortality, cardiovascular mortality, heart failure, coronary heart disease and stroke.…”

Section: Discussionmentioning

confidence: 78%

“…Out of the 879 studies retrieved from the search, 26 studies were relevant but 12 studies were excluded from the analysis (see online supplementary table S1). A total of 14 studies4 10–17 19–23 were included: 12 general population studies, 1 cohort with coronary heart disease19 and 1 cohort with hypertension 16…”

Section: Resultsmentioning

confidence: 99%

Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis

Kwok

Rashid

Beynon

et al. 2016

Heart

104

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Objective: First-degree atrioventricular block is frequently encountered in clinical practice and is generally considered a benign process. However, there is emerging evidence that prolonged PR interval may be associated with adverse outcomes. This study aims to determine if prolonged PR interval is associated with adverse cardiovascular outcomes and mortality. Methods:We searched MEDLINE and EMBASE for studies that evaluated clinical outcomes associated with prolonged and normal PR intervals. Relevant studies were pooled using random effects meta-analysis for risk of mortality, cardiovascular mortality, heart failure, coronary heart disease, atrial fibrillation and stroke or transient ischemic attack.Sensitivity analyses were performed considering the population type and use of adjustments.Results: Our search yielded 14 studies that were undertaken between 1972 and 2011 with 400,750 participants. Among the studies that adjusted for potential confounders, the pooled results suggest an increased risk of mortality with prolonged PR interval RR 1.24 95%CI 1.02-1.51, 5 studies. Prolonged PR interval was associated with significant risk of heart failure or left ventricular dysfunction (RR 1.39 95%CI 1.18-1.65, 3 studies) and atrial fibrillation (RR 1.45 95%CI 1.23-1.71, 8 studies) but not cardiovascular mortality, coronary heart disease or myocardial infarction or stroke or TIA. Similar observations were recorded when limited to studies of first-degree heart block. Conclusions:Data from observational studies suggests a possible association between prolonged PR interval and significant increases in atrial fibrillation, heart failure and mortality. Future prospective studies are needed to confirm the relationships reported, consider possible mechanisms and define the optimal monitoring strategy for such patients.

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“…in his work showed that among 3816 patients with hypertension the number of patients with atrioventricular block stage 1 was 14.3 %. It was demonstrated that atrioventricular block stage 1 is an independent factor in the future development of AF and left ventricle dysfunction in these patients [18]. Iskenderov B.G.…”

Section: Resultsmentioning

confidence: 99%

Features of cardiac rhythm disorders and conduction disturbances in patients with arterial hypertension

Vasylenko

2017

ZMJ

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Objective -to study features of cardiac rhythm disorders and conduction disturbances in patients with arterial hypertension.Methods of the study. Under our observation there were 110 patients with first-third degree hypertension stage II, aged 38 to 72 years (mean age -50.63 ± 1.34 years). The gender distribution of patients was as follows: 61 female (55 %) and 49 male patients (45 %). The control group comprised 30 healthy individuals, of whom 13 were male and 17 female (43 % and 57 % respectively) and whose mean age was 49.75 ± 1.83 years. Cardiac arrhythmias and conduction disorders were detected by means of Holter ECG. Statistical analysis was carried out on a personal computer, using such programs as Excel-7.0 (Microsoft Corp., USA) and Statistica ® for Windows 6.0 (StatSoft Inc., License number AXXR712D833214FAN5) through parametric and nonparametric methods.Results. Cardiac arrhythmias were found in 71 (65 %) patients with arterial hypertension and were characterized by the presence of supraventricular extrasystole in 43 (39 %) patients and paroxysmal atrial fibrillation in 10 (9 %) patients. Ventricular extrasystole and episodes of unstable ventricular tachycardia were diagnosed in 13 (12 %) and 5 (5 %) patients, respectively. In hypertensive patients supraventricular arrhythmias were detected in 2.8 times more likely (p < 0.01), and single ventricular premature beats -6.2 times more likely (p < 0.01) than the control group. It was found that in patients with moderate and severe hypertension observed a statistically significant increase in the number of single supraventricular and ventricular premature beats -21.5 % (p < 0.05) and 29.6 % (p < 0.05) respectively, compared with the subgroup of mild hypertension. Conclusions.Patients with arterial hypertension are characterized by a wide range of supraventricular and ventricular arrhythmias, namely extrasystole, atrial fibrillation, ventricular tachycardia.Особливості порушень серцевого ритму та провідності в пацієнтів з артеріальною гіпертензією А. М. ВасиленкоМета роботи -вивчити особливості порушень серцевого ритму та провідності у хворих з артеріальною гіпертензією.Матеріали та методи. Під нашим наглядом перебували 110 хворих на гіпертонічну хворобу II стадії з 1-3 ступенем артеріальної гіпертензії віком від 38 до 72 років (середній вік -50,63 ± 1,34 року). За гендерною ознакою пацієнти розподі-лились так: 61 жінка (55 %) і 49 хворих чоловіки (45 %). Контрольну групу становили 30 здорових осіб, з них 13 були чоловічої та 17 жіночої статі (43 та 57 % відповідно); середній вік -49,75 ± 1,83 року. Для виключення ішемічної хвороби серця всім пацієнтам виконували тести з фізичним навантаженням (велоергометрія, тредміл). Порушення серцевого ритму та провідності виявлялись шляхом холтерівського моніторування ЕКГ. Статистичний аналіз здійснили на персональному комп'ютері за допомогою таких програм, як Excel-7.0 (Microsoft Corp., США) та Statistica ® для Windows 6.0 (StatSoft Inc., ліцензія № AXXR712D833214FAN5) параметричними та непараметричними методами.Резуль...

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Aortic pulse wave velocity predicts mortality in chronic kidney disease stages 2–4

Abstract: These results provide the first direct evidence that in patients with CKD stage 2-4, increased aortic stiffness determined by aPWV is a strong independent predictor of all-cause mortality.

Cited by 93 publications

References 56 publications

Arterial Stiffness and Chronic Kidney Disease

Arterial Stiffness and Chronic Kidney Disease

Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis

Features of cardiac rhythm disorders and conduction disturbances in patients with arterial hypertension

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