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Prognostic value of carotid and radial artery reservoir-wave parameters in end-stage renal disease

Citation

Fortier, C and Cote, G and Mac-Way, F and Goupil, R and Desbiens, L-C and Desjardins, M-P and Marquis, K and Hametner, B and Wassertheurer, S and Schultz, MG and Sharman, JE and Agharazii, M, Prognostic value of carotid and radial artery reservoir-wave parameters in end-stage renal disease, Journal of the American Heart Association, 8, (13) Article e012314. ISSN 2047-9980 (2019) [Refereed Article]


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Copyright 2019 the authors. Licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/

DOI: doi:10.1161/JAHA.119.012314

Abstract

Background: Reservoir-wave approach is an alternative model of arterial hemodynamics based on the assumption that measured arterial pressure is composed of volume-related (reservoir pressure) and wave-related components (excess pressure). However, the clinical utility of reservoir-wave approach remains debatable.

Methods and Results: In a single-center cohort of 260 dialysis patients, we examined whether carotid and radial reservoir-wave parameters were associated with all-cause and cardiovascular mortality. Central pulse pressure and augmentation index at 75 beats per minute were determined by radial arterial tonometry through generalized transfer function. Carotid and radial reservoir-wave analysis were performed to determine reservoir pressure and excess pressure integral. After a median follow-up of 32 months, 171 (66%) deaths and 88 (34%) cardiovascular deaths occurred. In Cox regression analysis, carotid excess pressure integral was associated with a hazard ratio of 1.33 (95% CI , 1.14-1.54; P<0.001 per 1 SD) for all-cause and 1.45 (95% CI : 1.18-1.75; P<0.001 per 1 SD) for cardiovascular mortality. After adjustments for age, heart rate, sex, clinical characteristics and carotid-femoral pulse wave velocity, carotid excess pressure integral was consistently associated with increased risk of all-cause (hazard ratio per 1 SD, 1.30; 95% CI : 1.08-1.54; P=0.004) and cardiovascular mortality (hazard ratio per 1 SD, 1.31; 95% CI : 1.04-1.63; P=0.019). Conversely, there were no significant associations between radial reservoir-wave parameters, central pulse pressure, augmentation index at 75 beats per minute, pressure forward, pressure backward and reflection magnitude, and all-cause or cardiovascular mortality after adjustment for comorbidities.

Conclusions: These observations support the clinical value of reservoir-wave approach parameters of large central elastic vessels in end-stage renal disease.

Item Details

Item Type:Refereed Article
Keywords:aortic stiffness, end&#8208;stage renal disease, excess pressure, pulse wave analysis, pulse wave velocity, wave separation analysis
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
UTAS Author:Schultz, MG (Dr Martin Schultz)
UTAS Author:Sharman, JE (Professor James Sharman)
ID Code:133578
Year Published:2019
Deposited By:Menzies Institute for Medical Research
Deposited On:2019-07-02
Last Modified:2019-08-13
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