Pulse Wave Velocity: A Valuable Predictor for Cardio-Cerebrovascular Disease and Death in PD Patients

Xu, Tian; Xie, Jingyuan; Zong, Xue; Wang, Weiming; Ren, Hua; Chen, Nan

doi:10.1159/000433516

Cited by 8 publications

(9 citation statements)

References 26 publications

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“…Our results are in accordance with previous studies, which have shown that acPWV contributes to increased cardiovascular morbidity and mortality in patients with CKD 2–5 and those treated by hemo- and peritoneal dialysis [ 13 , 24 , 25 , 26 , 27 ]. Moreover, epidemiological studies have highlighted high AS as a risk factor for development of cardiovascular disease and mortality in different non-CKD populations, including those with no previous cardiovascular disease [ 28 , 29 ] or with uncomplicated essential hypertension [ 30 ].…”

Section: Discussionsupporting

confidence: 93%

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Significance of acPWV for Survival of Hemodialysis Patients

Petković¹,

Baralić²,

Brković

et al. 2020

Medicina

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Background and Objectives: Abnormal arterial stiffness (AS) is a major complication in end-stage kidney disease (ESKD) patients treated by dialysis. Our study aimed to determine the significance of AS for survival of prevalent dialysis patients, as well as its association with cardiovascular parameters or vascular calcification promoters/inhibitors or both and AS. Materials and Methods: The study involved 80 adult hemodialysis patients. Besides standard laboratory analyses, we also determined promoters and inhibitors of vascular calcification (bone biomarkers): serum levels of fibroblast growth factor 23 (FGF23), soluble Klotho, intact parathormone (iPTH), 1,25-dihydroxyvitamin D3, osteoprotegerin, sclerostin, AS measured as ankle carotid pulse wave velocity (acPWV), Ankle Brachial Index (ABI), and vascular calcification (VC) score. Patients were monitored for up to 28 months. According to the median acPWV value, we divided patients into a group with acPWV ≤ 8.8 m/s, and a group with acPWV > 8.8 m/s, and the two groups were compared. Results: Values for bone biomarkers were similar in both groups. Mean arterial blood pressure (MAP), central systolic and diastolic brachial blood pressure, heart rate, and pulse pressure were higher in the group with acPWV > 8.8 m/s than in the group with acPWV ≤ 8.8 m/s. The mortality was higher for patients with acPWV > 8.8 m/s at any given time over 28 months of follow-up. In multivariable analysis, predictors of higher acPWV were age >60.5, higher pulse rate, and higher central systolic or brachial diastolic blood pressure. Conclusions: According to our results, we advise the measurement of acPWV preferentially in younger dialysis patients for prognosis, as well as intervention planning before the development of irreversible changes in blood vessels. In addition, measuring central systolic blood pressure seems to be useful for monitoring AS in prevalent hemodialysis patients.

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Section: Discussionsupporting

confidence: 93%

“…Furthermore, in this population, mean and median reference values were provided for each age and blood pressure category [ 36 ]. Different acPWV cut-off values for survival of dialysis patients have been reported, from 16.6 m/s [ 13 ] up to 8.5 m/s [ 5 , 24 , 25 , 26 , 37 , 38 ]. There are a few possible explanations.…”

Section: Discussionmentioning

confidence: 99%

Significance of acPWV for Survival of Hemodialysis Patients

Petković¹,

Baralić²,

Brković

et al. 2020

Medicina

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“…cfPWV values have been noted to increase with advancing age [ 21 ]. Older age is also positively associated with cfPWV values in patients undergoing PD [ 5 ]. Vascular arterial wall aging is characterized by a decrease in elastic fibers and increase in collagen concentration, leading to increased arterial stiffness [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the Association for Research into Arterial Structure and Physiology Society considers the cfPWV value a useful vascular biomarker for primary and secondary CV disease prevention [ 4 ]. Higher cfPWV values also predict CV disease and death in patients undergoing peritoneal dialysis (PD) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Low serum adiponectin level is associated with central arterial stiffness in patients undergoing peritoneal dialysis

et al. 2020

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Objective: Adiponectin has antidiabetic, anti-atherosclerotic, and anti-inflammatory functions and protects against vascular damage. Carotid-femoral pulse wave velocity (cfPWV) is a noninvasive method for measuring central artery stiffness, which is known to be associated with cardiovascular disease in peritoneal dialysis (PD) patients. This study was conducted to evaluate the relationship between central arterial stiffness and serum adiponectin levels in PD patients. Materials and Methods: Fasting blood samples were obtained from 60 PD patients, and the cfPWV value was measured using a validated tonometry system. In this study, cfPWV values of >10 m/s were used to define the high arterial stiffness group according to the European Society of Hypertension and the European Society of Cardiology guidelines. Results: Among 60 patients with PD, 19 patients (31.7%) were included in the high arterial stiffness group. When compared to those in the control group, the high arterial stiffness group patients were older ( P = 0.029), had longer PD vintage ( P = 0.001), higher diastolic blood pressures ( P = 0.030), higher fasting glucose ( P = 0.014), and lower serum adiponectin levels ( P = 0.001). After multivariable logistic regression analysis, serum adiponectin (odds ratio, 0.612; 95% confidence interval: 0.426–0.879; P = 0.008) was identified as an independent predictor of arterial stiffness. The multivariable regression analysis also showed that the adiponectin level (β = −0.408; adjusted R 2 change = 0.183; P < 0.001) was negatively associated with cfPWV values in patients undergoing PD. Conclusion: Low serum adiponectin level is an independent marker of arterial stiffness in patients undergoing PD.

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“…Vascular calcification, which decreases systemic vascular compliance and increases systolic blood pressure, pulse pressure and pulse wave velocity (PWV) has been shown to be an important predictor for CVD in CKD patients [4, 5]. The carotid-femoral PWV is regarded as the golden standard in evaluation of arterial stiffness [6].…”

Section: Introductionmentioning

confidence: 99%

Is Sclerostin Level Associated with Cardiovascular Diseases in Hemodialysis Patients?

et al. 2018

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Background/Aims: The objective of this study is to evaluate the relation between sclerostin, arterial stiffness, and cardiovascular events (CVE) in hemodialysis patients (HD). Methods: Sclerostin level and carotid-femoral pulse wave velocity (PWV) in 97 HD patients and sclerostin level in 40 controls were measured. Results: Sclerostin level was significantly higher in patients than in controls. Sclerostin associated positively with age, male gender, cardiovascular disease, statin use, BMI, and PWV while negatively with alkaline phosphatase, parathormone (PTH), Kt/V, cinacalcet and vitamin D use in univariable correlation analyses. Sclerostin associated positively with male gender and statin use but negatively with PTH in multivariate regression analyses. During observation, 30 fatal or nonfatal CVEs were observed. While univariate correlation analysis showed a positive association between PWV and sclerostin, there was no relation between the two in multivariate regression analysis. Conclusion: Further studies are needed to understand the role of sclerostin in predicting PWV changes in HD patients.

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Pulse Wave Velocity: A Valuable Predictor for Cardio-Cerebrovascular Disease and Death in PD Patients

Cited by 8 publications

References 26 publications

Significance of acPWV for Survival of Hemodialysis Patients

Significance of acPWV for Survival of Hemodialysis Patients

Low serum adiponectin level is associated with central arterial stiffness in patients undergoing peritoneal dialysis

Is Sclerostin Level Associated with Cardiovascular Diseases in Hemodialysis Patients?

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