Comparative analysis of arterial stiffnes non invasively evaluated in hemodialyzed patients

  • Cinthia Galli Área de Investigación y Desarrollo Universidad de Favaloro (AIDUF), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires
  • Rodolfo Valtuille Fresenius FME Burzaco, Buenos Aires
  • Maia Daniela Percunte Facultad Regional Buenos Aires, Universidad Tecnológica Nacional, Buenos Aires
  • Nahuel Hernán Carrizo Facultad Regional Buenos Aires, Universidad Tecnológica Nacional, Buenos Aires
  • Daniel Bia Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo
  • Ricardo Armentano Área de Investigación y Desarrollo Universidad de Favaloro (AIDUF), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires
  • Edmundo Cabrera Fischer Área de Investigación y Desarrollo Universidad de Favaloro (AIDUF), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires
Keywords: aortic stiffness, pulse wave velocity, hemodialysis, arterial stiffness

Abstract

Introduction: Changes in arterial stiffness in hemodialysis patients occur both, in elastic and muscular vessels but only the aortic Pulse Wave Velocity (PWV) has demonstrated to be a high prognostic value index, however, muscular arteries are not involved in the aortic PWV measurement. Objectives: The purpose of this research was: a) to evaluate the aortic and carotid-radial PWV of hemodialysis patients, b) to repeat these measurements in the same cohort after 5 years comparing four different arterial stiffness indexes. Methods: 23 hemodialyzed patients carotid-femoral PWV (PWVcf) and  carotidradial (PWVcr) were evaluated and calculations were as follows: PWV ratio, PWV difference (/PWV), PWV mismatch and PWV percentage change (%PWV). These evaluations were performed using data obtained in 2007 (Time 1) and 2012 (Time 2). Results: PWV ratio showed a significant increase between measurements performed in Time 1 and 2 (from 1.1±0.3 to 1.4±0.4; p≤0.01). Similar increases in negative terms were found when /PWV was calculated from -0.9±3.0 to -2.7±2.9; p≤0.05). Calculated values of PWV mismatch increased significantly > (negative values) between Time 1 and 2 (from 0.0±0.1 to -0.1±0.1; p≤0.02) Percent changes of PWV between Time 1 and 2 (negative values) showed a significant increase (from -4.8±22.0 to -21.5±24.2; p≤0.05). Conclusions: Stiffness indexes, obtained in hemodialyzed patients including both elastic and muscular arteries used in this research showed statistically significant differences when two measures with 5 years interval were compared. However significance levels were not similar.

References

Blacher J, Demuth K, Guerin AP, Safar ME, Moatti N, London GM. Influence of biochemical alterations on arterial stiffness in patients with end-stage renal disease. Arterioscler Thromb Vasc Biol. 1998;18(4):535-41.

Boutouyrie P, Fliser D, Goldsmith D, Covic A, Wiecek A, Ortiz A, et al. Assessment of arterial stiffness for clinical and epidemiological studies: methodological considerations for validation and entry into the European Renal and Cardiovascular Medicine registry. Nephrol Dial Transplant. 2014;29(2):232-9.

Galli CN, Valtuille R, Graf S, Cabrera Fischer EI. Estudios no invasivos del acceso vascular. En: Armentano RL, Galli CN eds. El acceso vascular para hemodiálises: fundamentos biomecánicos para su estudio en la clínica médica. Buenos Aires, AICAVA, 2011; p. 119-220.

Guérin AP, Pannier B, Marchais SJ, London GM. Arterial structure and function in end-stage renal disease. Curr Hypertens Rep. 2008;10(2):107-11.

Fortier C, Mac-Way F, Desmeules S, Marquis K, De Serres SA, Lebel M, et al. Aortic-brachial stiffness mismatch and mortality in dialysis population. Hypertension. 2015;65(2):378-84.

Cabrera Fischer EI, Bia D, Valtuille R, Graf S, Galli C, Armentano RL. Vascular access localization determines regional changes in arterial stiffness. J Vasc Access. 2009;10(3):192-8.

Cabrera Fischer EI, Bia D, Galli C, Valtuille R, Zócalo Y, Wray S, et al. Hemodialysis decreases carotid-brachial and carotid-femoral pulse wave velocities: A 5-year follow-up study. Hemodial Int. 2015;19(3):419-28.

Bia D, Cabrera-Fischer EI, Zócalo Y, Galli C, Graf S, Valtuille R, et al. Vascular accesses for haemodialysis in the upper arm cause greater reduction in the carotid-brachial stiffness than those in the forearm: study of gender differences. Int J Nephrol. 2012; 2012:598512.

Covic A, Siriopol D. Pulse wave velocity ratio: the new “gold standard” for measuring arterial stiffness. Hypertension. 2015;65(2):289-90.

London GM, Safar ME, Pannier B. Aortic Aging in ESRD: Structural, Hemodynamic, and Mortality Implications. J Am Soc Nephrol. 2016;27(6):1837-46.

Zócalo Y, Bia D, Pérez Campos H, Armentano RL. Homoinjertos vasculares criopreservados. En: Armentano RL, Galli CN eds. El acceso vascular para hemodiálises: fundamentos biomecánicos para su estudio en la clínica médica. Buenos Aires, AICAVA, 2011; p. 221-44.

Christen AI, Sánchez RA, Baglivo HP, Armentano RL, Risk MR, Cabrera Fischer EI. Non-invasive assessment of systemic elastic behaviour in hypertensive patients: analysis of possible determinants. Med Prog Technol. 1997;21 Suppl:5-11.

Zhang Y, Agnoletti D, Protogerou AD, Topouchian J, Wang JG, Xu Y, et al. Characteristics of pulse wave velocity in elastic and muscular arteries: a mismatch beyond age. J Hypertens. 2013 Mar;31(3):554-9.

Cameron JD, Bulpitt CJ, Pinto ES, Rajkumar C. The aging of elastic and muscular arteries: a comparison of diabetic and nondiabetic subjects. Diabetes Care. 2003;26(7):2133-8.

Published
2017-04-28
How to Cite
1.
Galli C, Valtuille R, Percunte MD, Carrizo NH, Bia D, Armentano R, Cabrera Fischer E. Comparative analysis of arterial stiffnes non invasively evaluated in hemodialyzed patients. Rev Nefrol Dial Traspl. [Internet]. 2017Apr.28 [cited 2024Dec.28];36(1):26-3. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/53
Section
Original Article