Comparative anatomy and histology of the radial artery and the internal thoracic artery

Acar, Christophe; Va, Jebara; Portoghese, Michele; Fontaliran, F; Dervanian, Patrice; Jc, Chachques; Meininger,; Carpentier, Alain

doi:10.1007/bf01627759

Cited by 74 publications

(38 citation statements)

References 6 publications

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“…46 Although patients with ESRD have increased risk of accelerated atherosclerosis, 47,48 the described changes of the arterial wall are independent of this parameter since they have been shown to be present at the level of the radial artery, where atherosclerosis is practically absent. 44,49 Recently, Blacher et al 26 have demonstrated that increased aortic PWV is an independent risk factor of all-cause and CV mortality in haemodialysed patients, a finding recently confirmed by therapeutic trial. 50 All these previous studies have been conducted in patients with advanced uraemia.…”

Section: Pulse Wave Velocity Pulse Pressure and Renal Failurementioning

confidence: 94%

Diabetes mellitus and renal failure: effects on large artery stiffness

et al. 2001

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Diabetes mellitus and end-stage renal disease are two pathologic entities associated with increased cardiovascular risk. Several studies have shown that arterial stiffness is increased in both cases and contributes to the increased risk. In order to determine the effect of diabetes and renal failure on arterial stiffness, we conducted a case-control study. One hundred and twentytwo diabetic patients were compared to 122 non-diabetic patients matched to the study group for sex, age, mean arterial pressure, number and localisation of the atherosclerotic alterations. Arterial stiffness was assessed by automatic measurement of the aortic pulse wave velocity (PWV) and by measuring the peripheral and carotid pulse pressure (PP) and reflected waves through analysis of the pulse wave using the principle of applanation tonometry. Aortic PWV was significantly higher in the

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Section: Pulse Wave Velocity Pulse Pressure and Renal Failurementioning

confidence: 94%

Diabetes mellitus and renal failure: effects on large artery stiffness

et al. 2001

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“…16 Such findings are observed on central elastic and peripheral muscular arteries. 10,11,16 In particular, in vivo studies performed on the radial artery, a blood vessel poorly altered by aging and unmodified by atherosclerosis, 17 have shown that the major mechanism of vascular alterations was characterized by an increased stiffness of the vascular wall matrix, 18,19 a parameter consistently associated to "uremia" and not to high blood pressure. Studies in experimental uremia and in vitro in arteries of uremic patients have shown striking structural alterations involving an increase in wall thickness, cross-sectional media, and total extracellular matrix including collagen but no elastin.…”

Section: Large Artery Damage In End-stage Renal Diseasementioning

confidence: 99%

Arterial Stiffness and Kidney Function

2004

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Abstract-The vascular hallmark of subjects with end-stage renal disease undergoing hemodialysis is increased aortic stiffness, a phenomenon independent of mean arterial blood pressure, wall stress, and standard cardiovascular risk factors such as plasma glucose, cholesterol, obesity, and smoking. These observations suggest that subtle links might associate arterial stiffness and kidney function in normotensive and hypertensive populations. Recently, aortic pulse wave velocity and creatinine clearance have been shown to be statistically associated in subjects with plasma creatinine Յ130 mol/L, again independently of mean arterial blood pressure and classical cardiovascular risk factors. This association was even shown to predominate in subjects younger than age 55 years. In addition, acceleration of aortic pulse wave velocity with age was more important in these subjects than in untreated normotensive control individuals, and the phenomenon was consistently predicted by baseline plasma creatinine values. Among all antihypertensive drugs, angiotensin-converting enzyme inhibitors only were shown to exhibit a significant and independent effect on aortic stiffness. The use of these drugs was significantly associated with improvement of large aortic stiffness in subjects treated for hypertension. In conclusion, increased stiffness of central arteries is independently associated with reduced creatinine clearance in subjects with mild to severe renal insufficiency, indicating that kidney diseases may interact not only with small but also with large conduit arteries, independently of age, blood pressure level, and classical cardiovascular risk factors. Whether sodium, divalent ionic species (calcium, phosphates), and the renin-angiotensinaldosterone system play a role in such alterations remains to be elucidated. right's disease involves relatively well established links between uremia, high blood pressure, and cardiovascular (CV) complications, which were elegantly described from clinical observations at the end of the 19th century. In those days, biological and imaging tolls were of course quite limited, and exquisite clinical skill was critical for establishing such relationships of unique pathophysiological importance. The tremendous development of renal replacement therapy to handle chronic uremia, including dialysis techniques, over the past half century is associated with an increasing number of CV complications, which are poorly defined at this point in time, illustrating the complex relationships between renal failure and hypertension.Traditionally, one refers easily to three different mechanisms to explain these relationships. First, renal failure is associated with structural and/or functional alterations exclusively located in small resistance arteries. Second, hypertension-related CV complications affecting larger blood vessels of the brain and the heart are related to atherosclerosis, a morbid condition not necessarily immediately and exclusively linked to hypertension. Third, the kidney itself, also a majo...

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“…2,3 Because the Einc of the CCA is increased independently of BP and wall stress, the role of mechanical factors in the mechanism of elevated Einc does not seem dominantly involved. 2 Because higher values for Einc have been observed at the site of the radial artery, which is consistently devoid of atherosclerosis, 4 the "accelerated atherosclerosis" described in ESRD patients 5,6 does not seem responsible for this increase in Einc. Thus, it is relevant to determine in patients with ESRD whether biochemical and/or structural factors related to kidney alterations might influence the changes in Einc.…”

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confidence: 99%

Influence of Biochemical Alterations on Arterial Stiffness in Patients With End-stage Renal Disease

Blacher

Demuth

Guérin

et al. 1998

ATVB

190

115

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Abstract-The incremental elastic modulus of the common carotid and radial arteries is increased in patients with end-stage renal disease (ESRD), independently of blood pressure, wall stress, and the presence of atherosclerotic alterations. Whether biochemical factors may be involved in the arterial changes and related to renal dysfunction remain largely ignored. To assess this question, we measured aortic (carotid-femoral), upper-limb (carotid-radial), and lower-limb (femoral-tibial) pulse wave velocity (PWV) in 74 ESRD patients undergoing hemodialysis in comparison with 57 control subjects similar in age, sex ratio, and mean blood pressure. We evaluated arterial blood presure by sphygmomanometry, aortic calcifications and cardiac mass by echography, and routine biochemical parameters, total plasma homocysteine, and plasma endothelin levels by standard techniques. In the population of patients with ESRD, on the basis of multiple stepwise regression analysis, aortic PWV was positively and independently correlated with systolic blood pressure (PϽ.0001), age (PϽ.0001), prevalence of aortic calcification (Pϭ.0004), and the prevalence of diabetes mellitus (Pϭ.0043). Upper-limb PWV was influenced exclusively by mean blood pressure (PϽ.0001). Lower-limb PWV was positively and independently correlated with plasma total homocysteine (Pϭ.0004) and plasma endothelin (Pϭ.0187) only. At any vascular site, PWV was not independently correlated with tobacco consumption; plasma levels of cholesterol, triglyceride, fibrinogen, or hemoglobin; body mass index; or the presence of bilateral nephrectomy. Finally, plasma homocysteine was independently correlated with cardiac mass (Pϭ.0022). This study provides evidence that in ESRD patients, the stiffness of the arterial wall and cardiac mass are strongly influenced by biochemical factors related to the kidney alterations and are independent of age and blood pressure level. Increased plasma endothelin and homocysteine may be specifically involved in the vascular damage of lower limbs. (Arterioscler Thromb Vasc Biol. 1998;18:535-541.)

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Comparative anatomy and histology of the radial artery and the internal thoracic artery

Cited by 74 publications

References 6 publications

Diabetes mellitus and renal failure: effects on large artery stiffness

Diabetes mellitus and renal failure: effects on large artery stiffness

Arterial Stiffness and Kidney Function

Influence of Biochemical Alterations on Arterial Stiffness in Patients With End-stage Renal Disease

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