Extreme-Dipper Profile, Increased Aortic Stiffness, and Impaired Subendocardial Viability in Hypertension

Amah, G.; Ouardani, Rahma; Pasteur-Rousseau, Adrien; Voicu, Sébastian; Safar, Michel E.; Kubis, Nathalie; Bonnin, Philippe

doi:10.1093/ajh/hpw209

Cited by 18 publications

(8 citation statements)

References 27 publications

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“…A low SEVR has been associated with albuminuria [8-10] and haemoglobin [11], as well as with markers of inflammation in patients with rheumatoid arthritis [12]. Hypertensive patients with reduced coronary flow reserve [13], extreme dippers [14], patients with rheumatoid arthritis [15] or peripheral artery disease [16], women with type 2 diabetes [17] and highly proteinuric CKD patients with an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m 2 [18] have also been associated with a lower SEVR. Recently, a reduced SEVR was shown to predict cardiovascular mortality in CKD patients [19] and combined endpoint all-cause mortality and end-stage renal disease in patients with type 1 diabetes [10].…”

Section: Introductionmentioning

confidence: 99%

Derived Subendocardial Viability Ratio and Cardiovascular Events in Patients with Chronic Kidney Disease

et al. 2018

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Background: Chronic kidney disease (CKD) is a well-known mortality risk factor. The subendocardial viability ratio (SEVR) is one of the pulse wave analysis parameters that constitutes a non-invasive measure of coronary perfusion. We aimed to assess the prognostic value of the SEVR for cardiovascular outcome in non-dialysis CKD patients. Methods: A total of 98 CKD patients (mean age 60 years) were prospectively followed up from the date of the SEVR measurement until their death or the start of dialysis/transplantation, maximally up to 7.1 years (mean 5 years). According to the manufacturer’s instructions regarding normal SEVR values, the patients were divided into a low SEVR group (SEVR ≤130%, n = 26) and a normal SEVR group (SEVR > 130%, n = 72). Results: During the follow-up period, 13 patients (13.3%) suffered fatal and 23 patients (23.5%) suffered combined (non-fatal and fatal) cardiovascular events. In the patients who died of cardiovascular causes, the SEVR values were statistically significantly lower (130 vs. 154%; p = 0.017) than in those who survived. A Kaplan-Meier survival analysis showed that the cardiovascular survival rate in the low SEVR group of patients was statistically significantly lower (log-rank test: p < 0.001). Using an unadjusted Cox regression analysis, the patients in the low SEVR group had a 5.6-fold higher risk (95% CI: 1.8–17.3; p = 0.002) of fatal cardiovascular events and a 2.7-fold higher risk (95% CI: 1.1–6.3; p = 0.024) of combined fatal and non-fatal cardiovascular events. In the adjusted Cox regression model, the patients in the low SEVR group had a 16-fold higher risk (95% CI: 1.2–9.7; p = 0.004) of fatal cardiovascular events and a 7-fold higher risk (95% CI: 1–9.7; p = 0.009) of combined fatal and non-fatal cardiovascular events. Conclusions: An SEVR < 130% predicts fatal and non-fatal cardiovascular events in non-dialysis CKD patients.

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Section: Introductionmentioning

confidence: 99%

Derived Subendocardial Viability Ratio and Cardiovascular Events in Patients with Chronic Kidney Disease

et al. 2018

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“…Anyfanti et al (19) did not report differences in SEVR between healthy men and women, but they reported only on SEVR difference in patients with rheumatoid arthritis. Amah et al also found lower values of SEVR in women than in men in dippers and in extreme dippers (6). Women have lower SEVR than men, partly due to a faster resting heart rate, which reduces diastolic time (i.e., the time for myocardial perfusion) (20).…”

Section: Discussionmentioning

confidence: 95%

“…This ratio was designated as the subendocardial viability ratio (SEVR), which is related to the functioning of the heart and oxygen consumption, and the energy supply to the heart (4,5). Recent studies have shown the association between SEVR and albuminuria, extreme dipper profile, and cardiovascular mortality (6)(7)(8). Different circulating serum biomarkers are involved in the pathogenesis of cardiovascular complications in patients with CKD.…”

Section: Introductionmentioning

confidence: 99%

Subendocardial viability ratio, ambulatory blood pressure monitoring and serum biomarkers for cardiovascular disease in chronic kidney patients

Piko

Šrot

Hojs

et al. 2021

AMB

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Purpose: Chronic kidney disease (CKD) is associated with a higher prevalence of cardiovascular diseases. The pulse wave analysis measures the aortic pressure waveform based on noninvasive peripheral pressure recording. The subendocardial viability ratio, as part of the pulse wave analysis, is a noninvasivemeasure of microvascular coronary perfusion. Methods: In the present study, we investigated the relationship between the subendocardial viability ratio, 24-h ambulatory blood pressure measurements, and serum biomarkers to determine the risk for cardiovascular disease in patients with CKD. A pulse wave analysis using applanation tonometry was performed in 86 patients with CKD. Serum biomarkers were measured in patients, and the patients were grouped according to the median value of the subendocardial viability ratio. Results: The mean age of the patients was 60 ± 13 years; 65% of the patients were men, and the mean subendocardial viability ratio was 151% ± 34%. Patients with CKD in the lower subendocardial viability ratio group (<151%) had significantly lower hemoglobin (p=0.002) and higher NT-proBNP (p=0.034), serum phosphorus (p=0.04), augmentation index (p=0.003), 24-h pulse (p=0.004), and 24-h pulse pressure(p=0.003). Conclusion: Our findings suggest that patients with CKD with a subendocardial viability ratio below 151% have a higher cardiovascular risk.

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“…36 A reduction of coronary flow results from increased coronary tone and vasospasm, 37,38 and may cause an imbalance between myocardial oxygen supply and myocardial oxygen demand, resulting in nighttime ischemia. Amah and colleagues showed a significantly lower subendocardial viability ratio (diastolic pressure-time index [ie, available coronary blood supply]/systolic pressure-time index [ie, myocardial blood demand] ratio) in extreme-dippers than in dippers, 39 which corresponded to impaired subendocardial flow. 40,41…”

Section: Nighttime Dbp and Asymptomatic Myocardial Injurymentioning

confidence: 99%

Association of lower nighttime diastolic blood pressure and hypoxia with silent myocardial injury: The Japan Morning Surge‐Home Blood Pressure study

Kubota

Hoshide

Kario

2020

J of Clinical Hypertension

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Elevated blood pressure (BP), when assessed by not only conventional office BP but also out-of-office BP measurements, such as ambulatory BP monitoring (ABPM), has been well acknowledged to be a cardiovascular disease (CVD) risk. 1-4 In particular, elevated nighttime BP as assessed by ABPM has been associated with myocardial overload and has been shown to have more prognostic power than daytime BP. 5-13 On the other hand, excessive nighttime BP reduction may also be a CVD risk. Previous studies reported that marked nocturnal BP fall, that is, extreme-dipping, was associated with a risk of cerebral and myocardial ischemia, 14-18 but this issue is still controversial. Nighttime hypoxia induced by sleep-disordered breathing (SDB) has also been revealed to confer a risk of CVD events. 19-21 Various

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Extreme-Dipper Profile, Increased Aortic Stiffness, and Impaired Subendocardial Viability in Hypertension

Cited by 18 publications

References 27 publications

Derived Subendocardial Viability Ratio and Cardiovascular Events in Patients with Chronic Kidney Disease

Derived Subendocardial Viability Ratio and Cardiovascular Events in Patients with Chronic Kidney Disease

Subendocardial viability ratio, ambulatory blood pressure monitoring and serum biomarkers for cardiovascular disease in chronic kidney patients

Association of lower nighttime diastolic blood pressure and hypoxia with silent myocardial injury: The Japan Morning Surge‐Home Blood Pressure study

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