Vascular Dysfunction: A Key Player in Chronic Cardio-renal Syndrome

Tomiyama, Hirofumi; Yamashina, Akira

doi:10.2169/internalmedicine.54.4502

Cited by 16 publications

(16 citation statements)

References 47 publications

(69 reference statements)

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“…Many indicators have been used to evaluate arterial stiffness, including the stiffness index [8], the cardio-ankle vascular index [9] and the pulse wave velocity (PWV) [10, 11]. Among others, PWV is a widely-accepted method for measuring arterial stiffness in clinical practice [12] and a strong predictor of CVD mortality [10].…”

Section: Introductionmentioning

confidence: 99%

“…Among others, PWV is a widely-accepted method for measuring arterial stiffness in clinical practice [12] and a strong predictor of CVD mortality [10]. The brachium-ankle pulse wave velocity (baPWV) as an easy and well-standardized method, is closely correlated to central aortic PWV [11, 13]. Since glomerular filtration rate (GFR) is difficult to measure, GFR is calculated from the serum concentrations of endogenous filtration markers, which is called estimated glomerular filtration rate (eGFR) [14-16].…”

Section: Introductionmentioning

confidence: 99%

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Pulse Pressure, Instead of Brachium-Ankle Pulse Wave Velocity, is Associated with Reduced Kidney Function in a Chinese Han Population

Jia

Zhang

et al. 2017

Kidney Blood Press Res

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Background/Aims: In this study, we aim to investigate the association between renal function and arterial stiffness in a Chinese Han population, and further to discuss the effects of smoking on renal function. Methods: We collected the data of the brachium-ankle pulse wave velocity (baPWV), blood pressure, blood chemistry and smoking status. Then, the multiple linear regression was done to explore the relationship between estimated glomerular filtration (eGFR) and baPWV. Further, the parameters were compared among the four groups divided according to the quartiles of baPWV. Finally, the baPWV, eGFR and albuminuria values were compared between smokers and non-smokers. Results: baPWV is associated with eGFR in the correlation analysis and univariate linear regression model. After adjustment, the pulse pressure (PP) instead of baPWV showed a significant association with eGFR. Nevertheless, the eGFR values differed among the four baPWV groups; the baPWV values were significantly higher in the subjects at the CKD (eGFR<60 mL/min/1.73 m²) and the early CKD stage (eGFR60–80 mL/min/1.73 m²). The baPWV values and the ratio of proteinuria were significantly increased in smokers. Conclusion: PP but not baPWV is a predictor of declined renal function. Smokers have worse arterial stiffness and worse renal function.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pulse Pressure, Instead of Brachium-Ankle Pulse Wave Velocity, is Associated with Reduced Kidney Function in a Chinese Han Population

Jia

Zhang

et al. 2017

Kidney Blood Press Res

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“…The concept of ED as a link between cardiovascular disease and chronic kidney disease in CRS was reinforced by evidence of asymmetric dimethylarginine-mediated ED [7]. More recently, ED has been reported to be associated with type 2 CRS [8], type 1 diabetes mellitus [9], and chronic CRS [10]. …”

Section: Introductionmentioning

confidence: 99%

The Central Role of Endothelial Dysfunction in Cardiorenal Syndrome

2016

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Background: Endothelial dysfunction (ED) has emerged as a critical process in cardiorenal syndrome (CRS). The concept that ED is closely linked with cardiac and renal dysfunction has become an important target for CRS-related research and clinical practice. Summary: The sequence of events leading to ED is initiated by type I endothelial activation (almost immediately) and type II endothelial activation (over hours, days, and even months), followed by endothelial apoptosis and endothelial necrosis. The fact that ED is a continual cellular event divides this process into reversible ED (endothelial activation) and irreversible ED (endothelial apoptosis and necrosis). This basic research-defined concept may have clinical implications. Although most antihypertensive drugs (ACE inhibitors, statins, etc.) are effective in patients with hypertension and diabetes, some of them have proved to be ineffective, which may partly be attributed to irreversible ED. Even though the etiology of ED consists mainly of asymmetric dimethylarginine, nitric oxide, oxidative stress, and anti-endothelial cell antibodies, many other inducers of ED have been identified. In addition, a distinct role of ED has been reported for each type of CRS in humans. Key Messages: Further study is warranted to prove whether ED holds promise as a pharmacological target in CRS patients.

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“…These mechanisms have been associated with left ventricular dilatation and increases in myocardial collagen content, contributing to the HF phenotype [60]. Infection-related changes in cardio-renal function may exaggerate fluids shift, leading to volume overload and subsequently HF manifestation or decompensation [65]. Furthermore, histological evidence of myocarditis and myocardial necrosis has been demonstrated in patients following influenza-related deaths [66].…”

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

Beneficial Effects of Vaccination on Cardiovascular Events: Myocardial Infarction, Stroke, Heart Failure

et al. 2018

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Influenza and pneumococcal infections have been suggested to be potential risk factors for causing adverse cardiovascular events, especially in high-risk patients. Vaccination against respiratory infections in patients with established cardiovascular disease (CVD) could serve as a potential cost-effective intervention to improve their clinical outcomes and cardiac societies have encouraged it. Previous studies have shown that influenza vaccination reduce mortality, acute coronary syndromes and hospitalization in patients with coronary heart disease (CHD) and/or heart failure (HF). However, there is a paucity of randomized prospective clinical trials in the field of the pneumococcal vaccination, and additional higher-quality evidence is needed. Furthermore, questions around the role of vaccination in the primary prevention of CVD, the optimal dose and timing are largely unanswered. The pathophysiologic mechanism in which vaccination provides cardiovascular protection may be related to the modification of the immune-inflammatory model of atherogenesis. The present review summarizes the current evidence and understanding for vaccination against influenza and streptococcus pneumoniae in CHD, HF and stroke and highlights its beneficial effect in the reduction of adverse cardiovascular events.

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Vascular Dysfunction: A Key Player in Chronic Cardio-renal Syndrome

Cited by 16 publications

References 47 publications

Pulse Pressure, Instead of Brachium-Ankle Pulse Wave Velocity, is Associated with Reduced Kidney Function in a Chinese Han Population

Pulse Pressure, Instead of Brachium-Ankle Pulse Wave Velocity, is Associated with Reduced Kidney Function in a Chinese Han Population

The Central Role of Endothelial Dysfunction in Cardiorenal Syndrome

Beneficial Effects of Vaccination on Cardiovascular Events: Myocardial Infarction, Stroke, Heart Failure

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