Impact of Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Blood Pressure Index on Mortality in Hemodialysis Patients

Kitahara, Tokuyuki; Ono, Kumeo; Tsuchida, A; Kawai, Hironobu; Sakai, Masahiko; Ishii, Yoshitaka; Koyanagi, Hikaru; Noguchi, Toshiharu; Matsumoto, Takayuki; Sekihara, Tetsuo; Watanabe, Yukiyasu; Kanai, Hideo; Ishida, Hideyuki; Nojima, Yoshihisa

doi:10.1053/j.ajkd.2005.06.016

Cited by 166 publications

(140 citation statements)

References 21 publications

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“…There is controversy over the effect of disorders of lipid metabolism on aortic compliance. In several cross-sectional studies, lipid profile was not a determinant of PWV, 5,6,9,29 whereas serum triglyceride correlated positively with ba-PWV in hemodialysis patients 30 and increments in ba-PWV. 28 Furthermore, intermediate-density lipoprotein cholesterol, which contains cholesterol and triglyceride, was an independent risk factor for arteriosclerosis.…”

Section: Discussionmentioning

confidence: 99%

What factors accelerate aortic stiffening in hemodialysis patients? An observational study

Matsumae¹,

Abe

Nishimura³

et al. 2010

Hypertens Res

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Increased aortic stiffness is an independent predictor of death from cardiovascular disease in patients with end-stage renal disease (ESRD). Various factors that contribute to carotid-femoral pulse wave velocity (cfPWV) as a surrogate of aortic stiffness have been identified, but determinants of long-term worsening of aortic stiffness remain to be elucidated. To clarify the factors that accelerate aortic stiffness in hemodialysis patients, 148 patients with ESRD on hemodialysis were evaluated. At baseline, cfPWV and ankle-brachial blood pressure index (ABPI) were measured and clinical status including biochemical parameters, with or without hepatitis c virus (HCV) infection, diabetes mellitus (DM), cardiovascular disease, cerebrovascular disease and peripheral arterial disease at baseline, were evaluated. The cfPWV was measured again after a 3-year follow up and the annual change in cfPWV was calculated. The cfPWV decreased in 54 patients, worsened slowly in 47 (annual change in cfPWV ranged from 0 to 0.33 m s À1 per year), and worsened rapidly in 47 patients (annual change in cfPWV was more than 0.33 m s À1 per year). The prevalences of DM, HCV infection and peripheral arterial disease were the highest in the rapid progression group. Univariate analysis showed that age, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), LDL-C/HDL-C ratio, HCV infection, ABPI and number of vasculopathies were significantly associated with annual change in cfPWV. Stepwise regression analysis identified ABPI, LDL-C/HDL-C ratio and HCV infection as independent determinants of worsening of cfPWV. Further studies are needed to investigate the mechanism of HCV-related enhancement of aortic stiffness in ESRD patients.

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Section: Discussionmentioning

confidence: 99%

What factors accelerate aortic stiffening in hemodialysis patients? An observational study

Matsumae¹,

Abe

Nishimura³

et al. 2010

Hypertens Res

View full text Add to dashboard Cite

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“…15 However, there have been few longitudinal reports about the relationship between baPWV and mortality. [16][17][18] One study suggested that increases in baPWV were associated with an elevated risk of cardiovascular mortality in 298 community-dwelling older adults, but the optimal cutoff value of baPWV was not shown. 17 The purpose of this study was to evaluate the relationship between baPWV and 3-year mortality and to determine the optimal cutoff value of baPWV in terms of mortality among community-dwelling older adults.…”

Section: Introductionmentioning

confidence: 99%

Association between brachial–ankle pulse wave velocity and 3-year mortality in community-dwelling older adults

et al. 2010

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With aging, arterial stiffness increases and results in cardiovascular diseases. Recently, high brachial-ankle pulse wave velocity (baPWV), measured using a new noninvasive device to estimate arterial stiffness, was reported to be associated with the prevalence of cardiovascular diseases. The purpose of this study was to clarify the association between baPWV with 3-year mortality in community-dwelling older adults and to determine the cutoff value of baPWV in terms of mortality. A total of 530 subjects aged 65 years or older (men/women, 207:323; mean age, 76 years) participated. They were dichotomized by the median value of baPWV. Within 3 years, 30 deaths occurred, including 11 cardiovascular deaths. The high-baPWV group had a higher incidence of total deaths (high-baPWV group vs. low-baPWV group, 8.3 vs. 3.0%, respectively) and cardiovascular deaths (high-baPWV group vs. lowbaPWV group, 3.8 vs. 0.4%, respectively). A high-baPWV level was associated with an increased risk of 3-year total mortality after adjustment for age, sex and systolic blood pressure (hazard ratio for high baPWV vs. low baPWV¼2.98, 95% CI¼1.25-7.07) and with an increased risk of 3-year cardiovascular mortality (hazard ratio for high baPWV vs. low baPWV¼10.01, 95% CI¼1.21-82.49). A receiver-operating characteristic curve showed that the optimal cutoff value of baPWV for total mortality was 19.63 m s À1 , and for cardiovascular mortality it was 19.63 m s À1 . This study provides a preliminary finding that assessment of arterial stiffness by baPWV might be a useful method to predict mortality risk in community-dwelling older adults. Large longitudinal studies for extended periods of time are necessary to confirm the association.

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“…LVM, EF, and PWV have all been repeatedly demonstrated to be relevant predictors of cardiovascular morbidity and mortality in patients with ESRD (5)(6)(7)(8)(9). Regression of LVM has also been shown to be associated with a more favorable outcome in this population (10).…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial of Hemodiafiltration and Change in Cardiovascular Parameters

Mostovaya¹,

Bots

Dorpel

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objective Increased left ventricular mass (LVM), low ventricular ejection fraction (EF), and high pulse-wave velocity (PWV) relate to overall and cardiovascular mortality in patients with ESRD. The aim of this study was to determine the effect of online hemodiafiltration (HDF) versus low-flux hemodialysis (HD) on LVM, EF, and PWV.Design, setting, participants, & measurements Echocardiography was used to assess LVM and EF in 342 patients in the CONvective TRAnsport STudy followed for up to 4 years. PWV was measured in 189 patients for up to 3 years. Effect of HDF versus HD on LVM, EF, and PWV was evaluated using linear mixed models.Results Patients had a mean age of 63 years, and 61% were male. At baseline, median LVM was 227 g (interquartile range [IQR], 183-279 g), and median EF was 65% (IQR, 55%-72%). Median PWV was 9.8 m/s (IQR, 7.5-12.0 m/s). There was no significant difference between the HDF and HD treatment groups in rate of change in LVM (HDF: change, 20.9 g/yr [95% confidence interval (95% CI), 28.9 to 7.7 g]; HD: change, 12.5 g/yr [95% CI, 23.0 to 27.5 g]; P for difference=0. Conclusions Treatment with online HDF did not affect changes in LVM, EF, or PWV over time compared with HD.

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Impact of Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Blood Pressure Index on Mortality in Hemodialysis Patients

Cited by 166 publications

References 21 publications

What factors accelerate aortic stiffening in hemodialysis patients? An observational study

What factors accelerate aortic stiffening in hemodialysis patients? An observational study

Association between brachial–ankle pulse wave velocity and 3-year mortality in community-dwelling older adults

A Randomized Trial of Hemodiafiltration and Change in Cardiovascular Parameters

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