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Relation of stiffness parameter β to carotid arteriosclerosis and silent cerebral infarction in patients on chronic hemodialysis

  • Nephrology - Original Paper
  • Published:
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Abstract

Objective

Aortic stiffness measured by pulse wave velocity (PWV) predicts all-cause and cardiovascular mortality in hemodialysis (HD) patients. However, there is a lack of information on stiffness parameter β, another index of arterial stiffness, in HD patients. The aim of the present study was to investigate the clinical usefulness of stiffness parameter β in HD patients.

Materials and methods

We compared the relation of stiffness parameter β to carotid intima-media thickness (IMT) and plaque score estimated by carotid ultrasound and investigated the relationship between stiffness parameter β and silent cerebral infarction (SCI) in 64 HD patients.

Results

Stiffness parameter β was positively correlated with mean IMT (r = 0.318, P = 0.0113) and plaque score (r = 0.672, P < 0.0001). Stepwise regression analysis revealed that pulse pressure and age were found to be independent determinants of stiffness parameter β (partial correlation coefficients: β = 0.501 and P < 0.0001 for pulse pressure, β = 0.488 and P < 0.0001 for age). In addition, stiffness parameter β in patients with SCI (12.2 ± 3.9) was significantly higher than those (8.0 ± 2.4) in patients without SCI. However, there was no significant difference in mean IMT and plaque score in both groups.

Conclusion

These results suggest that arteriosclerosis assessed by stiffness parameter β is associated with atherosclerotic changes of carotid arteries and with the presence of SCI in HD patients.

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References

  1. Shoji T, Emoto M, Shinohara K et al (2001) Diabetes mellitus, aortic stiffness, and cardiovascular mortality in end-stage renal disease. J Am Soc Nephrol 12:2117–2124

    PubMed  CAS  Google Scholar 

  2. Blacher J, Safar ME, Guerin AP, Pannier B, Marchais SJ, London GM (2003) Aortic pulse wave velocity index and mortality in end-stage renal disease. Kidney Int 63:1852–1860. doi:10.1046/j.1523-1755.2003.00932.x

    Article  PubMed  Google Scholar 

  3. Mattace-Raso FU, van der Cammen TJ, Hofman A et al (2006) Arterial stiffness and risk of coronary heart disease and stroke. Circulation 113:657–663. doi:10.1161/CIRCULATIONAHA.105.555235

    Article  PubMed  Google Scholar 

  4. Asmar R, Topouchian J, Pannier B, Benetos A, Safar M (2001) Pulse wave velocity as endpoint in large-scale intervention trial: the Complior study. Scientific quality control, coordination and investigation committees of the complior study. J Hypertens 19:813–818. doi:10.1097/00004872-200104000-00019

    Article  PubMed  CAS  Google Scholar 

  5. Kubo T, Miyata M, Minagoe S, Setoyama S, Maruyama I, Tei C (2002) A simple oscillometric technique for determining new indices of arterial distensibility. Hypertens Res 25:351–358. doi:10.1291/hypres.25.351

    Article  PubMed  Google Scholar 

  6. Yamashina A, Tomiyama H, Takeda K et al (2002) Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 25:359–364. doi:10.1291/hypres.25.359

    Article  PubMed  Google Scholar 

  7. Munakata M, Sakuraba J, Tayama J et al (2005) Higher brachial-ankle pulse wave velocity is associated with more advanced carotid atherosclerosis in end-stage renal disease. Hypertens Res 28:9–14. doi:10.1291/hypres.28.9

    Article  PubMed  Google Scholar 

  8. Matsui Y, Kario K, Ishikawa J, Eguchi K, Hoshide S, Shimada K (2004) Reproducibility of arterial stiffness indices (pulse wave velocity and augmentation index) simultaneously assessed by automated pulse wave analysis and their associated risk factors in essential hypertensive patients. Hypertens Res 27:851–857. doi:10.1291/hypres.27.851

    Article  PubMed  Google Scholar 

  9. Niki K, Sugawara M, Chang D et al (2002) A new noninvasive measurement system for wave intensity: evaluation of carotid arterial intensity and reproducibility. Heart Vessels 17:12–21. doi:10.1007/s003800200037

    Article  PubMed  Google Scholar 

  10. Kizu A, Koyama H, Tanaka S et al (2003) Arterial wall stiffness is associated with peripheral circulation in patients with type 2 diabetes. Atherosclerosis 170:87–91. doi:10.1016/S0021-9150(03)00237-5

    Article  PubMed  CAS  Google Scholar 

  11. Leskinen Y, Lehtimaki T, Loimaala A et al (2003) Carotid atherosclerosis in chronic renal failure-the central role of increased plaque burden. Atherosclerosis 171:295–302. doi:10.1016/j.atherosclerosis.2003.08.010

    Article  PubMed  CAS  Google Scholar 

  12. Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R (1986) Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation 74:1399–1406

    PubMed  CAS  Google Scholar 

  13. Handa N, Matsumoto M, Maeda H et al (1990) Ultrasonic evaluation of early carotid atherosclerosis. Stroke 21:1567–1572

    PubMed  CAS  Google Scholar 

  14. Yambe M, Tomiyama H, Hirayama Y et al (2004) Arterial stiffening as a possible risk factor for both atherosclerosis and diastolic heart failure. Hypertens Res 27:625–631. doi:10.1291/hypres.27.625

    Article  PubMed  Google Scholar 

  15. London GM, Guerin AP, Marchais SJ et al (1996) Cardiac and arterial interactions in end-stage renal disease. Kidney Int 50:600–608. doi:10.1038/ki.1996.355

    Article  PubMed  CAS  Google Scholar 

  16. Hojs R (2000) Carotid intima-media thickness and plaques in hemodialysis patients. Artif Organs 24:691–695. doi:10.1046/j.1525-1594.2000.06466.x

    Article  PubMed  CAS  Google Scholar 

  17. Kato A, Takita T, Maruyama Y, Hishida A (2004) Chlamydial infection and progression of carotid atherosclerosis in patients on regular hemodialysis. Nephrol Dial Transplant 19:2539–2546. doi:10.1093/ndt/gfh416

    Article  PubMed  Google Scholar 

  18. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539–553. doi:10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S

    Article  PubMed  CAS  Google Scholar 

  19. Daugirdas JT (1993) Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. J Am Soc Nephrol 4:1205–1213

    PubMed  CAS  Google Scholar 

  20. Taniwaki H, Kawagishi T, Emoto M et al (1999) Correlation between the intima-media thickness of the carotid artery and aortic pulse-wave velocity in patients with type 2 diabetes. Vessel wall properties in type 2 diabetes. Diabetes Care 22:1851–1857. doi:10.2337/diacare.22.11.1851

    Article  PubMed  CAS  Google Scholar 

  21. van Popele NM, Grobbee DE, Bots ML et al (2001) Association between arterial stiffness and atherosclerosis. The Rotterdam study. Stroke 32:454–460

    PubMed  Google Scholar 

  22. Paini A, Boutouyrie P, Calvet D, Tropeano A-I, Laloux B, Laurent S (2006) Carotid and aortic stiffness: determinants of discrepancies. Hypertension 47:371–376. doi:10.1161/01.HYP.0000202052.25238.68

    Article  PubMed  CAS  Google Scholar 

  23. Kawada H, Sumimoto T, Okayama H, Hiwada K (2001) Structure and function of the ventricle and carotid artery in hemodialysis patients. Hypertens Res 24:221–227. doi:10.1291/hypres.24.221

    Article  PubMed  CAS  Google Scholar 

  24. Makita S, Nakamura M, Hiramori K (2005) The association of C-reactive protein levels with carotid intima-media complex thickness and plaque formation in the general population. Stroke 36:2138–2142. doi:10.1161/01.STR.0000181740.74005.ee

    Article  PubMed  CAS  Google Scholar 

  25. London GM, Marchais SJ, Guerin AP, Metivier F, Adda H, Pannier B (2003) Inflammation, arteriosclerosis, and cardiovascular therapy in hemodialysis patients. Kidney Int Suppl 84:S88–S93. doi:10.1046/j.1523-1755.63.s84.25.x

    Article  PubMed  Google Scholar 

  26. Tseke P, Grapsa E, Stamatelopoulos K et al (2006) Atherosclerotic risk factors and carotid stiffness in elderly asymptomatic HD patients. Int Urol Nephrol 38:801–809. doi:10.1007/s11255-006-9000-1

    Article  PubMed  Google Scholar 

  27. Kobayashi S, Okada K, Koide H et al (1997) Subcortical silent brain infarction as a risk for clinical stroke. Stroke 28:1932–1939

    PubMed  CAS  Google Scholar 

  28. Fisher CM (1982) Lacunar strokes and infarcts. Rev Neurol 32:871–976

    CAS  Google Scholar 

  29. Nakatani T, Naganuma T, Uchida J et al (2003) Silent cerebral infarction in hemodialysis patients. Am J Nephrol 23:86–90. doi:10.1159/000068034

    Article  PubMed  Google Scholar 

  30. Naganuma T, Uchida J, Tsuchida K et al (2005) Silent cerebral infarction predicts vascular events in hemodialysis patients. Kidney Int 67:2434–2439. doi:10.1111/j.1523-1755.2005.00351.x

    Article  PubMed  Google Scholar 

  31. Kanters SD, Elgersma OE, Banga JD, van Leeuwen MS, Algra A (1998) Reproducibility of measurements of intima-media thickness and distensibility in the common carotid artery. Eur J Vasc Endovasc Surg 16:28–35. doi:10.1016/S1078-5884(98)80088-9

    Article  PubMed  CAS  Google Scholar 

  32. Dart AM, Gatzka CD, Kingwell BA et al (2006) Brachial blood pressure but not carotid arterial waveforms predict cardiovascular events in elderly female hypertensives. Hypertension 47:785–790. doi:10.1161/01.HYP.0000209340.33592.50

    Article  PubMed  CAS  Google Scholar 

  33. Karaman O, Albayrak R, Colbay M et al (2008) Carotid hemodynamic parameters in hemodialysis patients. Int Urol Nephrol 40:779–784. doi:10.1007/s11255-007-9314-7

    Article  PubMed  Google Scholar 

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Acknowledgements

The study was supported by grants from the Japan Research Promotion Society for Cardiovascular Diseases and Educational Institute for Integrated Medical Sciences (IREIIMS).

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Authors and Affiliations

  1. Department of Medicine, Kidney Center, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Tetsuya Ogawa, Nami Matsuda, Ayuko Fujiu & Kosaku Nitta

  2. Hidaka Hospital, Takasaki, Gunma, Japan

    Makoto Shimada, Hideki Ishida & Yoshitaka Ando

Authors
  1. Tetsuya Ogawa
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  2. Makoto Shimada
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  3. Hideki Ishida
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  4. Nami Matsuda
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  5. Ayuko Fujiu
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  6. Yoshitaka Ando
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  7. Kosaku Nitta
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Correspondence to Tetsuya Ogawa.

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Ogawa, T., Shimada, M., Ishida, H. et al. Relation of stiffness parameter β to carotid arteriosclerosis and silent cerebral infarction in patients on chronic hemodialysis. Int Urol Nephrol 41, 739–745 (2009). https://doi.org/10.1007/s11255-009-9526-0

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  • DOI: https://doi.org/10.1007/s11255-009-9526-0

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