Published online before print March 7, 2005, doi: 10.1161/01.HYP.0000159190.71253.c3
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Hypertension. 2005;45:592.)
© 2005 American Heart Association, Inc.
Original Articles |
Stiffness of Capacitive and Conduit Arteries
Prognostic Significance for End-Stage Renal Disease Patients
From Service d’Hémodialyse (B.P., A.P.G., S.J.M., G.M.L.), Hôpital F.H. Manhès, Centre de Diagnostic (M.E.S.), Hôtel-Dieu, Paris, France.
Correspondence to Dr. Gérard M. London, Hôpital F.H. Manhès, 8 rue Roger Clavier, Fleury-Mérogis 91712, France. E-mail glondon{at}club-internet.fr
The aorta is the principal capacitive element of the arterial tree and its increased stiffness, determined by measurement of aortic pulse wave velocity (PWV), is a strong independent predictor of cardiovascular mortality in the general population and end-stage renal disease (ESRD) patients. Whether stiffness of ESRD patients’ peripheral arteries has the same prognostic value has never been investigated. A cohort of 305 ESRD patients was followed for 70±49 months (mean±SD). Ninety-six deaths of cardiovascular origin occurred. At entry into the study, together with standard clinical and biochemical analyses, patients’ aortic, brachial artery, and femorotibial PWV were determined. Based on Kaplan–Meier survival curve analyses and Cox proportional hazards analyses, adjusted for age, pulse pressure, and clinical data, aortic PWV was a significant and independent predictor of outcome. Neither brachial artery nor femotibial artery stiffness was able to predict cardiovascular outcome. Receiver operating characteristic curve analysis of aortic PWV indicated the cutoff value of 10.75 m/s, with 84% sensitivity, 73% specificity, 87% negative predictive value, and 72% positive predictive value. These results provide evidence that, in ESRD, increased stiffness of capacitive arteries, like the aorta, is an independent strong predictor of cardiovascular mortality, whereas stiffness of peripheral conduit arteries had no prognostic value.
Key Words: arteries • mortality • renal disease
This article has been cited by other articles:
 |
|
 |
|
  M. E. Safar and J. Blacher Carotid versus brachial pulse pressure in elderly persons. J. Am. Coll. Cardiol., June 24, 2008; 51(25): 2440 - 2441. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Sabit, C. E. Bolton, J. R. Cockcroft, and D. J. Shale Arterial Stiffness and Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., April 15, 2008; 177(8): 929 - 930. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Frimodt-Moller, A. H. Nielsen, A.-L. Kamper, and S. Strandgaard Reproducibility of pulse-wave analysis and pulse-wave velocity determination in chronic kidney disease Nephrol. Dial. Transplant., February 1, 2008; 23(2): 594 - 600. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. DeLoach and R. R. Townsend Vascular Stiffness: Its Measurement and Significance for Epidemiologic and Outcome Studies Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 184 - 192. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Cunningham, J. Floege, G. London, M. Rodriguez, and C. M. Shanahan Clinical Outcomes in Secondary Hyperparathyroidism and the Potential Role of Calcimimetics NDT Plus, January 1, 2008; 1(suppl_1): i29 - i35. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Sabit and D. J. Shale Vascular Structure and Function in Chronic Obstructive Pulmonary Disease: A Chicken and Egg Issue? Am. J. Respir. Crit. Care Med., December 15, 2007; 176(12): 1175 - 1176. [Full Text] [PDF]
|
|
|
|
|
|
M. Yoshida, H. Tomiyama, J. Yamada, Y. Koji, K. Shiina, M. Nagata, and A. Yamashina Relationships among Renal Function Loss within the Normal to Mildly Impaired Range, Arterial Stiffness, Inflammation, and Oxidative Stress Clin. J. Am. Soc. Nephrol., November 1, 2007; 2(6): 1118 - 1124. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. L. Schiffrin, M. L. Lipman, and J. F.E. Mann Chronic Kidney Disease: Effects on the Cardiovascular System Circulation, July 3, 2007; 116(1): 85 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Roman, R. B. Devereux, J. R. Kizer, E. T. Lee, J. M. Galloway, T. Ali, J. G. Umans, and B. V. Howard Central Pressure More Strongly Relates to Vascular Disease and Outcome Than Does Brachial Pressure: The Strong Heart Study Hypertension, July 1, 2007; 50(1): 197 - 203. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Laurent and P. Boutouyrie Recent Advances in Arterial Stiffness and Wave Reflection in Human Hypertension Hypertension, June 1, 2007; 49(6): 1202 - 1206. [Full Text] [PDF]
|
|
|
|
 |
|
 A. R. Khoshdel, S. L. Carney, B. R. Nair, and A. Gillies Better Management of Cardiovascular Diseases by Pulse Wave Velocity: Combining Clinical Practice with Clinical Research using Evidence-Based Medicine Clin. Med. Res., March 1, 2007; 5(1): 45 - 52. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Laurent, J. Cockcroft, L. Van Bortel, P. Boutouyrie, C. Giannattasio, D. Hayoz, B. Pannier, C. Vlachopoulos, I. Wilkinson, H. Struijker-Boudier, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications Eur. Heart J., November 1, 2006; 27(21): 2588 - 2605. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Kimoto, T. Shoji, K. Shinohara, S. Hatsuda, K. Mori, S. Fukumoto, H. Koyama, M. Emoto, Y. Okuno, and Y. Nishizawa Regional Arterial Stiffness in Patients with Type 2 Diabetes and Chronic Kidney Disease J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2245 - 2252. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Labat, R. S. A. Cunha, P. Challande, M. E. Safar, and P. Lacolley Respective contribution of age, mean arterial pressure, and body weight on central arterial distensibility in SHR Am J Physiol Heart Circ Physiol, April 1, 2006; 290(4): H1534 - H1539. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Paini, P. Boutouyrie, D. Calvet, A.-I. Tropeano, B. Laloux, and S. Laurent Carotid and Aortic Stiffness: Determinants of Discrepancies Hypertension, March 1, 2006; 47(3): 371 - 376. [Abstract] [Full Text] [PDF]
|
|