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Aortic-Brachial Stiffness Mismatch and Mortality in Dialysis Population

We hypothesized that increased aortic stiffness (central elastic artery) combined with a decrease in brachial stiffness (peripheral muscular artery) leads to the reversal of the physiological stiffness gradient (ie, mismatch), promoting end-organ damages through increased forward pressure wave trans... Full description

Journal Title: Hypertension (Dallas Tex. 1979), 2015-02, Vol.65 (2), p.378-384
Main Author: Fortier, Catherine
Other Authors: Mac-Way, Fabrice , Desmeules, Simon , Marquis, Karine , De Serres, Sacha A , Lebel, Marcel , Boutouyrie, Pierre , Agharazii, Mohsen
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: American Heart Association, Inc
ID: ISSN: 0194-911X
Link: https://www.ncbi.nlm.nih.gov/pubmed/25452473
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recordid: cdi_proquest_miscellaneous_1645781474
title: Aortic-Brachial Stiffness Mismatch and Mortality in Dialysis Population
format: Article
creator:
  • Fortier, Catherine
  • Mac-Way, Fabrice
  • Desmeules, Simon
  • Marquis, Karine
  • De Serres, Sacha A
  • Lebel, Marcel
  • Boutouyrie, Pierre
  • Agharazii, Mohsen
subjects:
  • Age Factors
  • Aged
  • Brachial Artery
  • Carotid Arteries
  • Comorbidity
  • Confounding Factors (Epidemiology)
  • Diabetes Mellitus - epidemiology
  • Female
  • Femoral Artery
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic - mortality
  • Kidney Failure, Chronic - physiopathology
  • Kidney Failure, Chronic - therapy
  • Male
  • Middle Aged
  • Overweight - epidemiology
  • Peritoneal Dialysis
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Pulse Wave Analysis
  • Radial Artery
  • Renal Dialysis
  • Vascular Stiffness
ispartof: Hypertension (Dallas, Tex. 1979), 2015-02, Vol.65 (2), p.378-384
description: We hypothesized that increased aortic stiffness (central elastic artery) combined with a decrease in brachial stiffness (peripheral muscular artery) leads to the reversal of the physiological stiffness gradient (ie, mismatch), promoting end-organ damages through increased forward pressure wave transmission into the microcirculation. We, therefore, examined the effect of aortic-brachial stiffness mismatch on mortality in patients in need of dialysis. In a prospective observational study, aortic-brachial arterial stiffness mismatch (pulse wave velocity ratio) was assessed using carotid-femoral pulse wave velocity divided by carotid-radial pulse wave velocity in 310 adult patients on dialysis. After a median follow-up of 29 months, 146 (47%) deaths occurred. The hazard ratio (HR) for mortality related to PWV ratio in a Cox regression analysis was 1.43 (95% confidence interval [CI], 1.24–1.64; P
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleAortic-Brachial Stiffness Mismatch and Mortality in Dialysis Population
creatorFortier, Catherine ; Mac-Way, Fabrice ; Desmeules, Simon ; Marquis, Karine ; De Serres, Sacha A ; Lebel, Marcel ; Boutouyrie, Pierre ; Agharazii, Mohsen
creatorcontribFortier, Catherine ; Mac-Way, Fabrice ; Desmeules, Simon ; Marquis, Karine ; De Serres, Sacha A ; Lebel, Marcel ; Boutouyrie, Pierre ; Agharazii, Mohsen
descriptionWe hypothesized that increased aortic stiffness (central elastic artery) combined with a decrease in brachial stiffness (peripheral muscular artery) leads to the reversal of the physiological stiffness gradient (ie, mismatch), promoting end-organ damages through increased forward pressure wave transmission into the microcirculation. We, therefore, examined the effect of aortic-brachial stiffness mismatch on mortality in patients in need of dialysis. In a prospective observational study, aortic-brachial arterial stiffness mismatch (pulse wave velocity ratio) was assessed using carotid-femoral pulse wave velocity divided by carotid-radial pulse wave velocity in 310 adult patients on dialysis. After a median follow-up of 29 months, 146 (47%) deaths occurred. The hazard ratio (HR) for mortality related to PWV ratio in a Cox regression analysis was 1.43 (95% confidence interval [CI], 1.24–1.64; P<0.001 per 1 SD) and was still significant after adjustments for confounding factors, such as age, dialysis vintage, sex, cardiovascular disease, diabetes mellitus, smoking status, and weight (HR, 1.23; 95% CI1.02–1.49). The HRs for changes in 1 SD of augmentation index (HR, 1.35; 95% CI, 1.12–1.63), carotid-femoral pulse wave velocity (HR, 1.29; 95% CI, 1.11–1.50), and carotid-radial pulse wave velocity (HR, 0.80; 95% CI, 0.67–0.95) were statistically significant in univariate analysis, but were no longer statistically significant after adjustment for age. In conclusion, aortic-brachial arterial stiffness mismatch was strongly and independently associated with increased mortality in this dialysis population. Further studies are required to confirm these finding in lower-risk groups.
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languageeng
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subjectAge Factors ; Aged ; Brachial Artery ; Carotid Arteries ; Comorbidity ; Confounding Factors (Epidemiology) ; Diabetes Mellitus - epidemiology ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - physiopathology ; Kidney Failure, Chronic - therapy ; Male ; Middle Aged ; Overweight - epidemiology ; Peritoneal Dialysis ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Pulse Wave Analysis ; Radial Artery ; Renal Dialysis ; Vascular Stiffness
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descriptionWe hypothesized that increased aortic stiffness (central elastic artery) combined with a decrease in brachial stiffness (peripheral muscular artery) leads to the reversal of the physiological stiffness gradient (ie, mismatch), promoting end-organ damages through increased forward pressure wave transmission into the microcirculation. We, therefore, examined the effect of aortic-brachial stiffness mismatch on mortality in patients in need of dialysis. In a prospective observational study, aortic-brachial arterial stiffness mismatch (pulse wave velocity ratio) was assessed using carotid-femoral pulse wave velocity divided by carotid-radial pulse wave velocity in 310 adult patients on dialysis. After a median follow-up of 29 months, 146 (47%) deaths occurred. The hazard ratio (HR) for mortality related to PWV ratio in a Cox regression analysis was 1.43 (95% confidence interval [CI], 1.24–1.64; P<0.001 per 1 SD) and was still significant after adjustments for confounding factors, such as age, dialysis vintage, sex, cardiovascular disease, diabetes mellitus, smoking status, and weight (HR, 1.23; 95% CI1.02–1.49). The HRs for changes in 1 SD of augmentation index (HR, 1.35; 95% CI, 1.12–1.63), carotid-femoral pulse wave velocity (HR, 1.29; 95% CI, 1.11–1.50), and carotid-radial pulse wave velocity (HR, 0.80; 95% CI, 0.67–0.95) were statistically significant in univariate analysis, but were no longer statistically significant after adjustment for age. In conclusion, aortic-brachial arterial stiffness mismatch was strongly and independently associated with increased mortality in this dialysis population. Further studies are required to confirm these finding in lower-risk groups.
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0Age Factors
1Aged
2Brachial Artery
3Carotid Arteries
4Comorbidity
5Confounding Factors (Epidemiology)
6Diabetes Mellitus - epidemiology
7Female
8Femoral Artery
9Follow-Up Studies
10Humans
11Kaplan-Meier Estimate
12Kidney Failure, Chronic - mortality
13Kidney Failure, Chronic - physiopathology
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15Male
16Middle Aged
17Overweight - epidemiology
18Peritoneal Dialysis
19Prognosis
20Proportional Hazards Models
21Prospective Studies
22Pulse Wave Analysis
23Radial Artery
24Renal Dialysis
25Vascular Stiffness
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authorFortier, Catherine ; Mac-Way, Fabrice ; Desmeules, Simon ; Marquis, Karine ; De Serres, Sacha A ; Lebel, Marcel ; Boutouyrie, Pierre ; Agharazii, Mohsen
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6Diabetes Mellitus - epidemiology
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8Femoral Artery
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17Overweight - epidemiology
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24Renal Dialysis
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abstractWe hypothesized that increased aortic stiffness (central elastic artery) combined with a decrease in brachial stiffness (peripheral muscular artery) leads to the reversal of the physiological stiffness gradient (ie, mismatch), promoting end-organ damages through increased forward pressure wave transmission into the microcirculation. We, therefore, examined the effect of aortic-brachial stiffness mismatch on mortality in patients in need of dialysis. In a prospective observational study, aortic-brachial arterial stiffness mismatch (pulse wave velocity ratio) was assessed using carotid-femoral pulse wave velocity divided by carotid-radial pulse wave velocity in 310 adult patients on dialysis. After a median follow-up of 29 months, 146 (47%) deaths occurred. The hazard ratio (HR) for mortality related to PWV ratio in a Cox regression analysis was 1.43 (95% confidence interval [CI], 1.24–1.64; P<0.001 per 1 SD) and was still significant after adjustments for confounding factors, such as age, dialysis vintage, sex, cardiovascular disease, diabetes mellitus, smoking status, and weight (HR, 1.23; 95% CI1.02–1.49). The HRs for changes in 1 SD of augmentation index (HR, 1.35; 95% CI, 1.12–1.63), carotid-femoral pulse wave velocity (HR, 1.29; 95% CI, 1.11–1.50), and carotid-radial pulse wave velocity (HR, 0.80; 95% CI, 0.67–0.95) were statistically significant in univariate analysis, but were no longer statistically significant after adjustment for age. In conclusion, aortic-brachial arterial stiffness mismatch was strongly and independently associated with increased mortality in this dialysis population. Further studies are required to confirm these finding in lower-risk groups.
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