Effect of the arteriovenous access for hemodialysis on subendocardial viability ratio, pulse pressure and hospitalizations

Vizinho, Ricardo; Santos, Catarina C.; Lucas, Carlos; Adragão, Teresa; Barata, José Diogo

doi:10.1007/s40620-014-0056-1

Cited by 7 publications

(8 citation statements)

References 32 publications

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“…In a study by Di Micco et al a greater reduction of SEVR values (third tertile) significantly predicted cardiovascular mortality in CKD stage 3–4 patients, but there is no data about albuminuria . In a study by Vizinho et al, which included 44 pre‐dialysis CKD patients, 2 months after vascular access creation was found a 4.9‐fold higher risk of all‐cause hospitalizations and a higher risk of cardiovascular hospitalizations in patients with SEVR ≤113% . The results of all these studies showed that reduction of SEVR could be a valuable tool for the assessment of cardiovascular risk.…”

Section: Discussionmentioning

confidence: 99%

Subendocardial Viability Ratio Is Impaired in Highly Proteinuric Chronic Kidney Disease Patients With Low Estimated Glomerular Filtration Rate

et al. 2016

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Proteinuria and estimated glomerular filtration rate (eGFR) are markers of chronic kidney disease (CKD) and cardiovascular disease. With applanation tonometry, pulse wave analysis and many hemodynamic data are available. One of them is the subendocardial viability ratio (SEVR) which represents a non-invasive measure of myocardial perfusion related to the work of the heart. The aim of our study was to investigate the importance of SEVR in proteinuric CKD patients and healthy subjects. We performed a cross-sectional study in a cohort of 90 non-dialysis CKD patients and 39 healthy controls. SEVR was assessed by radial applanation tonometry (SphygmoCor, Atcor, Australia). Blood samples and urine albumin-to-creatinine ratio (UACR) were analyzed. CKD patients were divided in four groups according to the UACR and eGFR: CKD group 1: UACR > 1000 mg/g and eGFR < 30 mL/min; CKD group 2: UACR > 1000 mg/g and eGFR >30 mL/min; CKD group 3: UACR <1000 mg/g and eGFR < 30 mL/min and CKD group 4: UACR < 1000 mg/g and eGFR >30 mL/min. Using one-way ANOVA, we found a statistically significant difference in SEVR only between CKD group 1 and all other CKD groups and healthy control group (P < 0.022). Results of our study show that only CKD patients with UACR more than 1000 mg/g and eGFR below 30 mL/min have significantly lower SEVR.

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Section: Discussionmentioning

confidence: 99%

Subendocardial Viability Ratio Is Impaired in Highly Proteinuric Chronic Kidney Disease Patients With Low Estimated Glomerular Filtration Rate

et al. 2016

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“…Furthermore, the creation of an arteriovenous access is independently associated with an impairment of pre‐existing left ventricular hypertrophy . This is not a minor point since a significant improvement of arterial function accompanied by a worsening of left ventricular function has been demonstrated in hemodialyzed patients . About this, Vizinho et al.…”

Section: Discussionmentioning

confidence: 99%

“…17 This is not a minor point since a significant improvement of arterial function accompanied by a worsening of left ventricular function has been demonstrated in hemodialyzed patients. 18 About this, Vizinho et al showed that despite the decrease in arterial pulse pressure parameters, the creation of a vascular access for hemodialysis was also associated with a reduction of subendocardial viability ratio (an index of myocardial oxygen supply and demand), which predicted a worse clinical outcome. 18 The mentioned facts indicate caution on the clinical implication of the obtained results in the arterial tree and show the necessity of more clinical research in which the arterial stiffness characterization was accompanied by a cardiac function analysis in hemodialyzed patient.…”

Section: Figurementioning

confidence: 99%

Hemodialysis decreases carotid‐brachial and carotid‐femoral pulse wave velocities: A 5‐year follow‐up study

Fischer

Bia²,

Galli

et al. 2015

Hemodialysis International

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Aortic stiffness is a prognostic parameter associated with patient mortality. Vascular access creation has been shown to have effects on arterial stiffness both in the aorta and in the upper limb arteries in chronically hemodialyzed patients (CHPs). However, no longitudinal studies have been conducted in order to characterize the evolution of arterial stiffness in CHPs. The aims of this work were (a) to measure baseline pulse wave velocity (PWV) in the carotid-femoral and in right and left carotid-brachial pathways in a cohort of CHP and (b) to conduct a 5-year prospective study on the same cohort to determine possible time-related differences. Pulse wave velocity was measured both in the carotid-femoral and in the carotid-brachial pathways, and clinical and biochemical parameters were collected in 25 CHPs, which were followed up after a 5-year lapse. Right and left carotid-brachial pathway PWV values showed significant decreases after the 5-year follow-up, independently of the presence of the vascular access (P < 0.001). Additionally, baseline carotid-brachial PWV was significantly higher (P < 0.001) than values measured 5 years later for upper limbs with vascular access (11.97 ± 2.97 m/sec vs. 6.76 ± 1.48 m/sec, respectively) and without vascular access (12.25 ± 2.38 m/sec vs. 7.18 ± 1.88 m/sec, respectively). Similarly, PWV values in the carotid-femoral pathway decreased significantly (P < 0.001) over the same period (13.27 ± 2.96 m/sec vs. 9.75 ± 2.99 m/sec, respectively). The 5-year follow-up of PWV showed significant decreases in both carotid-brachial and carotid-femoral pathways. The general changes in arterial stiffness could be related to the vascular access creation, hemodialysis therapy, and to the improvement of arterial pressure management.

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“…Subendocardial viability ratio (SEVR) derived from aortic pressure is an index of myocardial perfusion relative to cardiac workload . SEVR is independently associated with cardiovascular events and is suggested for the early detection of individual cardiovascular risk .…”

mentioning

confidence: 99%

“…12,13 Subendocardial viability ratio (SEVR) derived from aortic pressure is an index of myocardial perfusion relative to cardiac workload. 2,[14][15][16] SEVR is independently associated with cardiovascular events 16,17 and is suggested for the early detection of individual cardiovascular risk. 18,19 A recent study has shown that SEVR obtained from radial pressure may provide equivalent information as aortic SEVR.…”

mentioning

confidence: 99%

A New Tonometric Device for Radial Augmentation Index and Subendocardial Viability Ratio: Potential Use in Health Screening

Wang

Zhang

et al. 2014

J of Clinical Hypertension

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Augmentation index (AIx) and subendocardial viability ratio (SEVR) are widely accepted indices of wave reflection and myocardial oxygen demand relative to supply. This study aimed to validate a new tonometric device (IIM‐2010A) for obtaining AIx and SEVR from radial artery. A total of 68 outpatients (32 men and 36 women) aged 20 to 76 years (44.7±16.6 years) recruited from a health screening center participated in the study. AIx was obtained from radial pressure using the HEM‐9000AI and IIM‐2010A devices, while SEVR was measured from carotid pressure with the tonometric method and from radial pressure by the IIM‐2010A device. In a subgroup of 24 patients, the measurements of AIx and SEVR were repeated after an interval of 10 minutes. The correlation of radial AIx between the IIM‐2010A and HEM‐9000AI devices was highly significant (r=0.956, P<.01). Radial SEVR determined from IIM‐2010A was also highly related to carotid SEVR (r=0.864, P<.01), although the value was about 13.1% lower. There was no statistically significant difference between the repeated measurements of both indices. The lower coefficient of variation (2.9% vs 4.3% for AIx, 3.3% vs 4.1% for SEVR) and higher intraclass correlation coefficient (0.96 vs 0.91 for AIx, 0.93 vs 0.86 for SEVR) of IIM‐2010A confirmed better short‐term reproducibility, compared with the HEM‐9000AI device and carotid tonometry. The new tonometric device IIM‐2010A is effective and reproducible in calculating radial AIx and SEVR and has potential use in health screening.

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Effect of the arteriovenous access for hemodialysis on subendocardial viability ratio, pulse pressure and hospitalizations

Cited by 7 publications

References 32 publications

Subendocardial Viability Ratio Is Impaired in Highly Proteinuric Chronic Kidney Disease Patients With Low Estimated Glomerular Filtration Rate

Subendocardial Viability Ratio Is Impaired in Highly Proteinuric Chronic Kidney Disease Patients With Low Estimated Glomerular Filtration Rate

Hemodialysis decreases carotid‐brachial and carotid‐femoral pulse wave velocities: A 5‐year follow‐up study

A New Tonometric Device for Radial Augmentation Index and Subendocardial Viability Ratio: Potential Use in Health Screening

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