cfPWV In Patients Research Articles

Serum Lipoprotein(a) Levels as a Predictor of Aortic Stiffness in Patients on Long-Term Peritoneal Dialysis.

BACKGROUND Lipoprotein (a) [Lp(a)] is associated with atherosclerosis and cardiovascular mortality in patients with kidney failure. Aortic stiffness (AS), measured primarily by carotid-femoral pulse wave velocity (cfPWV), reflects vascular aging and precedes end-organ failure. This study aimed to evaluate the association between serum Lp(a) levels and cfPWV in patients undergoing peritoneal dialysis (PD). MATERIAL AND METHODS In this cross-sectional study, which included 148 patients with long-term PD for end-stage kidney failure, cfPWV was measured using a cuff-based method. AS was defined as a cfPWV exceeding 10 m/s, and an enzyme-linked immunosorbent assay was used to determine serum Lp(a) levels. Univariate and multivariate regression analyses were performed to identify the clinical correlates of AS. RESULTS There were 32 (21.6%) patients diagnosed with AS. Based on the multivariate logistic regression analysis, the odds ratio for AS was 1.007 (95% confidence interval, 1.003-1.011; P=0.001) for every 1 mg/L increase in Lp(a) levels. Multivariate linear regression analysis showed that Lp(a) (P<0.001), age (P=0.003), waist circumference (P=0.008), systolic blood pressure (P=0.010), and diabetes mellitus (P<0.001) were positively associated with cfPWV. The area under the receiver operating characteristic curve for Lp(a) in differentiating AS from non-AS was 0.770 (95% confidence interval, 0.694-0.835; P<0.0001). CONCLUSIONS Serum Lp(a) level was independently associated with cfPWV and AS in patients with PD.

Positive Association of Serum Galectin-3 with the Development of Aortic Stiffness of Patients on Peritoneal Dialysis.

A novel cardiovascular stress biomarker known as galectin-3 might be useful for anticipating adverse cardiovascular outcomes. The objective of the current investigation was to assess the association between serum galectin-3 levels and aortic stiffness (AS) in 196 patients on peritoneal dialysis. An enzyme-linked immunosorbent examination and a cuff-based volumetric displacement were employed to determine the levels of serum galectin-3 and the carotid-femoral pulse wave velocity (cfPWV), respectively. The AS group had 48 patients in total (24.5%) with cfPWV greater than 10 m/s. The AS group, when compared with the group without AS, had a significantly higher prevalence of diabetes mellitus and hypertension in addition to greater fasting glucose levels, waist circumference, systolic blood pressure, and serum galectin-3 levels. Multivariate logistic and linear regression analysis demonstrated that serum glactin-3 levels, in addition to gender and age, were significantly and independently associated with cfPWV and AS. Serum galectin-3 levels were linked with AS, according to a receiver operating characteristic curve analysis, with an area under the curve of 0.648 (95% confidence interval, 0.576-0.714; p = 0.0018). In summary, there was a significant correlation between serum galectin-3 levels and cfPWV in patients undergoing peritoneal dialysis therapy for end-stage kidney disease.

Urinary IL-18 is associated with arterial stiffness in patients with type 2 diabetes.

ObjectiveDiabetic kidney disease (DKD) has been shown to be associated with an excess risk of cardiovascular death. Inflammation has been considered central to type 2 diabetes (T2D) pathophysiology, and inflammation markers have been linked to cardiovascular disease. The serum and urinary IL-18 levels were significantly elevated in patients with T2D; however, whether interleukin 18 (IL-18) are associated with the severity of arterial stiffness remains to be determined. This study examined the relationship of IL-18 levels with pulse wave velocity (PWV) as a reflector for arterial stiffness in patients with T2D.MethodsA total of 180 participants with T2D who had undergone PWV examination were enrolled. Serum and urinary IL-18 levels were measured using sandwich enzyme linked immunosorbent assay (ELISA) kits. Arterial stiffness was determined by carotid–femoral PWV (cf-PWV) and carotid–radial PWV (cr-PWV).ResultsThe urinary IL-18 levels correlated positively with cf-PWV in patients with T2D with DKD (r = 0.418, p < 0.001); however, we found no significant correlation between urinary IL-18 and cf-PWV in diabetic subjects without DKD. In addition, we found no significant correlation between urinary IL-18 and cr-PWV in participants with T2D with or without DKD. Moreover, the association remained significant when controlling for arterial stiffness risk factors, urinary albumin-to-creatinine ratio and estimated glomerular filtration rate. cf-PWV was greater in the higher group of urinary IL-18 than in the lower group. Nevertheless, we found no significant correlation between serum IL-18 and cf-PWV in participants with T2D.ConclusionThe urinary IL-18 levels appear to be associated with greater cf-PWV, suggesting the link between urinary IL-18 and arterial stiffness in patients with T2D.

EFFECT OF SACUBITRIL-VALSARTAN ON EARLY RENAL FUNCTION AND VASCULAR FUNCTION IN PATIENTS DURING PERIMENOPAUSE WITH HYPERTENSION

Objective: To evaluate the effects of Sacubitril-Valsartan on early renal function and vascular function in patients during perimenopause with hypertension. Design and method: This study was a prospective, randomized, positive control and open label test. The subjects were 427 perimenopausal women (30–65 years old) with mild or moderate hypertension who were treated in the Department of Cardiovascular Medicine of the Second Hospital of Lanzhou University. They were randomly assigned to Sacubitril-Valsartan group (n = 165) or valsartan group (n = 262) for 24 weeks. Renal function, urinary renal function and vascular function were evaluated at baseline and 24 weeks after treatment. Results: There was no significant difference in the clinical baseline data between patients with sacubitril-valsartan and patients with valsartan (P&gt; 0.05). Comparison of the systolic blood pressure (oSBP) and diastolic blood pressure(oDBP)before and after treatment: the baseline vs. 24-week difference between the sacubitril-valsartan group and the valsartan group was statistically significant (p &lt; 0.001). The carotid-femoral pulse wave velocity (cfPWV) in the vascular function indexes of the sacubitril-valsartan group was significantly improved (p &lt; 0.001). The improvement of valsartan group was not obvious. Other vascular function parameters such as cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) were not significantly improved in the two groups. Urinary microalbumin (MAU)was significantly improved in both blood renal function and urine renal function. The improvement was observed in the sacubitril-valsartan group (p &lt; 0.001) and valsartan group (p = 0.027), but the improvement was stronger in the sacubitril-valsartan group (p &lt; 0.001). Conclusions: Sacubictril-valsartan has a stronger antihypertensive effect than valsartan in patients during perimenopause with hypertension, and can improve MAU and cfPWV in patients.

AORTIC STIFFNESS AND INDEXES OF DISEASE SEVERITY IN SUBJECTS WITH PREVIOUS COVID-19 PNEUMONIA: A FOLLOW-UP STUDY

Objective: Up to date the possibility of a vascular damage due to COVID-19 pneumonia is a not clarified. We searched for relationships between the carotid-femoral pulse wave velocity (cfPWV) and clinical and biochemical markers of severity of the infectious disease, after hospital discharge, in a group of patients who had been admitted in care units. Design and method: In 69 subjects (age 58 ± 13 years, 36 males), previously admitted in hospital because of COVID-19 pneumonia, we evaluated at the time of hospital admission anthropometric parameters, blood pressure, history of arterial hypertension or other diseases, drugs, smoking and alcohol habit, physical activity level, and indexes of infectious disease severity, such as the SIMEU score, need for invasive oxygen delivery, PaO2, PaCo2, inflammatory markers such as white blood cells count, levels of proadrenomedulline (proADM), reactive C protein, procalcitonin, IL- 6, glomerular filtration rate (GFR), troponin, mioglobin, B natriuretic peptide. After an average 2 months follow-up the cfPWV was measured. Results: At univariate analysis the cfPWV was significantly and positively related to age (r = 0.454, P &lt; 0.001), body mass index (r = 0.436, P = 0.016), waist circumference (r = 0.345, P = 0.004), levels of plasma glucose (r = 0.430, P = 0.001), proADM (r = 0.456, P = 0.006), IL-6 (r = 0.280, P = 0.037), mioglobin (r = 0.443, P = 0.001) and inversely related to GFR (r = -0.289, P = 0.023). The cfPWV was higher in diabetics subjects than in non-diabetics (P = 0.011), and in patients who had needed invasive oxygen support (P = 0.044). There was no difference in cfPWV in patients with or without history of arterial hypertension or with different blood pressure levels at admission. At multivariate analysis the cfPWV was independently associated with invasive oxygen support (B = 0.168, P = 0.012), body mass index (B = 0.180, P = 0.001), waist circumference (B = 0.162, P = 0.002), GFR (B = 0.078, P = 0.008), and proADM levels (B = 0.161, P = 0.003). Conclusions: In patients who recovered from COVID-19 pneumonia the aortic stiffness is associated with severity of disease and levels of proADM, but not with history of hypertension. Patients with more higher proADM levels in acute phase of the infectious disease could need a longer follow-up evaluation of the CFPWV after the recovering from disease to search for long time vascular damage.

A Retrospective Cohort Study of the Association between Serum Osteopontin Levels and Aortic Stiffness in Hypertensive Patients.

By suppressing mineralization and preventing ectopic calcium deposits, osteopontin (OPN) has an inhibitory effect on vascular calcification. Also, there is an association between OPN and aortic stiffness (AS). We aimed to investigate the association between serum OPN levels and AS measured by carotid–femoral pulse wave velocity (cfPWV) in hypertensive patients. Baseline characteristics and fasting blood sampling of 120 participants with hypertension and 120 participants without hypertension were acquired. Serum OPN concentrations were determined by enzyme-linked immunosorbent assay. In total, 43 (35.9%) participants were assigned to the AS group with cfPWV of >10 m/s in hypertensive patients. There were more patients with diabetes mellitus, old age, high systolic blood pressure, high serum intact parathyroid hormone (iPTH), elevated C-reactive protein, and high OPN levels in the AS group compared with the control group in hypertensive participants. A multivariate logistic regression analysis discloses that age, SBP, serum OPN, and iPTH levels were independently associated with AS in hypertensive patients. Moreover, according to a multivariate forward stepwise linear regression analysis, OPN level is positively associated with cfPWV. In conclusion, serum OPN level is assumed to be a potential biomarker to predict AS and is positively associated with cfPWV in patients with hypertension.

Increased Serum Adipocyte Fatty Acid-Binding Protein Concentrations Are Associated with Aortic Stiffness in Nondialysis Diabetic Kidney Disease

BACKGROUND: Adipocyte fatty acid-binding protein (A-FABP) is a novel adipokine with proinflammatory properties that contributes to the development of cardiovascular disease. This cross-sectional study evaluated the correlation between serum A-FABP and aortic stiffness in patients with stages 3-5 nondialysis chronic kidney disease due to type 2 diabetes mellitus (T2DM). METHODS: Fasting blood samples were obtained from 96 patients with stages 3-5 nondialysis chronic kidney disease due to T2DM. Pressure applanation tonometry was used to measure the carotid-femoral pulse wave velocity (cfPWV). Patients with a cfPWV ＞ 10 m/s were defined as having increased aortic stiffness according to the guidelines of the European Society of Hypertension and European Society of Cardiology 2013. Serum A-FABP levels were determined using a commercial enzyme immunoassay. RESULTS: There were 53 (55.2%) patients in the aortic stiffness group, of which higher prevalence rates were found for the male sex (P = 0.015), older age (P = 0.025), higher systolic blood pressure (BP) (P = 0.001), diastolic BP (P = 0.037), urine albumin/creatinine ratio (P = 0.007), serum levels of total cholesterol (P = 0.030), low-density lipoprotein cholesterol (P = 0.043), and A-FABP (P ＜ 0.001) compared with the group with normal aortic stiffness. After adjusting for factors that are significantly associated with aortic stiffness based on multivariable logistic regression analysis, serum A-FABP (odds ratio, 1.487; 95% confidence interval, 1.210-1.829; P ＜ 0.001) was an independent predictor of aortic stiffness in patients with diabetes-associated stages 3-5 nondialysis chronic kidney disease. Multivariable regression analysis with forward stepwise selection revealed that the serum level of logarithmically transformed A-FABP (β = 0.587; adjusted R^2 change, 0.426; P ＜ 0.001) was positively associated with cfPWV in patients with diabetes-associated stages 3-5 nondialysis chronic kidney disease. CONCLUSION: After adjusting for significant confounders, the serum A-FABP level was positively correlated with cfPWV and was an independent predictor of aortic stiffness in patients with diabetes-associated stages 3-5 nondialysis chronic kidney disease.

Relationship Between Resting Heart Rate and Carotid–Femoral Pulse Wave Velocity in the Elderly With Prehypertension

Abstract Background To investigate the relationship between resting heart rate and carotid–femoral pulse wave velocity (cfPWV) in patients with prehypertension. Methods A total of 288 outpatients with prehypertension and 326 normotensive outpatients from the First Affiliated Hospital of Fujian Medical University were enrolled between March 2017 and March 2019. Body weight, resting heart rate, and blood pressure of all patients were recorded. Blood biochemical indexes and cfPWV were determined. Results Compared with the normotensive controls, cfPWV in the prehypertension group was significantly higher (P &amp;lt; 0.01). There was an increase in cfPWV with advancing age in both prehypertension and control groups, and cfPWV in males was higher than females. In the prehypertension group, after stratified with age and gender, partial correlation analysis showed that resting heart rate was positively correlated with cfPWV (r = 0.230, P &amp;lt; 0.01). After adjusted for other cardiovascular risk factors, multivariable stepwise regression analysis indicated that resting heart rate, age, and gender were independently associated with cfPWV in the prehypertension group (all P &amp;lt; 0.01). Moreover, resting heart rate was independently associated with cfPWV in the patients with prehypertension aged ≥60 years in both males and females (all P &amp;lt; 0.01). However, in patients with prehypertension aged &amp;lt;60 years, no significant correlation was observed between resting heart rate and cfPWV. Conclusions In the elderly with prehypertension, resting heart rate is independently associated with cfPWV.

The Relationship Between Carotid–Femoral Pulse Wave Velocity, Pulse Pressure, and Carotid Intima–Media Thickness in the Patients With Hypertension

Abstract Background To investigate the relationships between pulse pressure, carotid intima–media thickness (CIMT), and carotid–femoral pulse wave velocity (cfPWV) in patients with hypertension. Methods A total of 469 patients with hypertension and 274 subjects with normal blood pressure were enrolled and subdivided based on their cfPWV (≥ or &amp;lt;10 m/s), CIMT (≥ or &amp;lt;1 mm), and age (≥ or &amp;lt;65 years old). Blood pressure was measured in all subjects and pulse pressure was calculated. Pearson correlation analysis and multiple linear regression analysis were used to analyze the influencing factors of cfPWV. Results cfPWV, pulse pressure, and CIMT in patients with hypertension were higher than those in patients with normal blood pressure (9.56 ± 1.93 vs. 8.46 ± 1.47 m/s, 58.6 ± 13.5 vs. 49.2 ± 10.3 mm Hg, 0.93 ± 0.18 vs. 0.82±0.17 mm, all P &amp;lt; 0.05). In patients with hypertension, pulse pressure and CIMT in the increased cfPWV group were significantly higher than those in the normal cfPWV group (all P &amp;lt; 0.05), and cfPWV and pulse pressure were significantly higher in the elderly than the younger age group (all P &amp;lt; 0.05). Multiple linear regression stepwise analysis showed that pulse pressure, age, heart rate, gender, and fasting blood glucose were the influencing factors of cfPWV in all subjects (all P &amp;lt; 0.05), and stratified analysis showed that pulse pressure was the influencing factor of cfPWV regardless of age and gender. CIMT was an influential factor of cfPWV in the younger age group (&amp;lt;65 years old), but not in elderly patients (≥65 years old). Conclusions Pulse pressure is an important influencing factor of cfPWV in patients with hypertension, and CIMT is associated with cfPWV in hypertensive patients less than 65 years old.

Correlations between Total Antioxidant Capacity and 8-Hydroxydeoxyguanosine with Carotid-Femoral Pulse Wave Velocity in Chronic Kidney Disease

BACKGROUND: Chronic kidney disease (CKD) is often associated with an increased risk of cardiovascular disease. Cardiovascular disease in CKD can be affected by oxidative stress and inflammation. The oxidative stress can affect arterial stiffness, especially in patients with CKD, which will increase the risk of cardiovascular disease. This study aimed to explain the correlation between total antioxidant capacity (TAC) and 8-hydroxydeoxyguanosine (8-OHdG) with carotid-femoral pulse wave velocity (cf-PWV) in patients with CKD.METHODS: Forty-three CKD patients was included in this cross-sectional study. TAC was measured from serum samples by colorimetric method and 8-OHDG was measured from urine by enzyme-linked immunoassay method. cf-PWV was measured by Doppler ultrasound as a diagnostic tool for arterial stiffness.RESULTS: Significant correlations were found between age, estimated glomerular filtration rate (e-GFR), Hemoglobin A1C (HbA1C), serum creatinine, cystatin-C, and severity of CKD with urinary 8-OHdG levels. Serum creatinine, cystatin-C, severity of CKD, age, high-density lipoprotein (HDL), e-GFR, and HbA1C also had significant correlations with serum TAC levels. Other significant correlations between e-GFR, HbA1C, serum creatinine, cystatin-C, and severity of CKD with cf-PWV were also obtained. A significant negative correlation was obtained between serum TAC and cf-PWV with moderate levels of correlation coefficient (r=-0.504).CONCLUSION: There was a negative correlation between TAC and cf-PWV, but there was no significant correlation between 8-OHdG and cf-PWV in patients with CKD.KEYWORDS: chronic kidney disease, total antioxidant capacity, 8-hydroxydeoxyguanosine, carotid-femoral pulse wave velocity

Effects of Angiotensin-Converting Enzyme Inhibitors on Arterial Stiffness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

To determine the effects of ACEIs on arterial stiffness, a meta-analysis of randomized controlled trials was conducted. Relevant articles that investigated the effects of ACEIs on arterial stiffness from PubMed, Embase, and the Cochrane library from inception to September 2018 were systematically retrieved. The investigated outcomes included brachial-ankle pulse wave velocity (ba-PWV) and carotid-femoral PWV (cf-PWV) by using weighted mean differences (WMDs) and 95% confidence intervals (CIs) with the random-effects model. A total of 17 RCTs including 1,458 individuals were included. The summary results indicated no significant differences between ACEIs and control for ba-PWV and cf-PWV. Also, no significant differences between ACEI and control for ba-PWV and cf-PWV were observed in hypertensive patients, while the therapeutic effects of ACEI versus placebo showed statistically significant difference. Moreover, subgroup analysis indicated that the levels of ba-PWV were significantly associated if the study was conducted in Western countries, mean age <60.0 years, percentage male ≥60.0%, compared with ARBs, baseline PWV <10.0, and high-quality study. Furthermore, the significant levels of cf-PWV in patients who received ACEIs were observed when percentage male was ≥60.0% and the studies were of high-quality. Finally, no significant differences were observed between ACEIs and other antihypertensive drugs regarding the changes of systolic blood pressure (SBP) and diastolic blood pressure (DBP). The overall analysis suggested no significant differences between ACEIs and other antihypertensive drugs for ba-PWV and cf-PWV levels, whereas ACEIs versus placebo showed lower levels of ba-PWV and cf-PWV.

Arterial Stiffness, Galectin-3, Tgf-Beta1 And Diastolic Dysfunction In Patients With Atrial Fibrillation

Background and Aims: Carotid-femoral pulse wave velocity (cfPWV) characterizes arterial stiffness is associated with increased risk of cardiovascular complications. The objective of this study was to compare cfPWV in patients with atrial fibrillation(AFib) and healthy individuals and to identify the relationship between arterial stiffness, diastolic function of left ventricle(DFLV) and serum levels of galectin-3(Gal-3), transforming growth factor beta1(TGF-beta1) - substances with profibrogenic effects.

0246: Is the measurement of carotid-femoral pulse wave velocity useful in patients with peripheral artery disease?

The carotid-femoral pulse-wave velocity (cfPWV) is predictive for cardiovascular events in general population and in patients with coronary artery disease (CAD). Patients with peripheral artery disease (PAD) are high cardiovascular risk, but the interest of cfPWV has never been assessed in this case. We sought to compare cfPWV in severe cases of PAD and CAD, and to assess its prognostic value in the former group. From 01/12 to 06/13 we measured cfPWV in patients referred to our hospital either for CABG or for limb revascularization for severe PAD. Patients with CAD with ankle-brachial index >0.90 were excluded. In PAD patients, baseline data and risk factors were compared in those with cfPWV>10m/s vs. those ≤10m/s. During follow-up, the following outcomes were collected: death, amputation and MACE (death, or stroke or myocardial infarction). We studied 162 patients (76 with PAD and 86 with CAD, age 69 vs. 67 yrs, p=0.25), with similar sex and risk factors distribution, except for diabetes (54% vs 20%, p<0.05). PAD patients had higher cfPWV than those with CAD (11.3±3.7 vs. 9.8±3.0m/s, p<0.007). In patients with PAD, 50% had a cfPWV>10m/s. These patients were older (72 vs. 66 yrs, p<0.001) with higher rates of diabetes (76% vs 56%, p<0.001) than PAD patients with cfPWV ≤10m/s, but did not differ regarding other risk factors. The cfPWV was found lower in the presence of aorto-iliac disease than in case of more distal PAD (9.5±2.5 vs. 11.8±3.9m/s, p<0.001). During follow-up of 10.5±5.7 months of PAD patients, 17.1% deceased, 5.3% had amputation, and MACE occurred in 19.7% of cases. We found no association between cfPWV and events (HR for death: 0.95, p=0.28; HR for amputation: 1.02, p=0.65; HR for MACE: 0.98, p=0.29). Patients with PAD have stiffer aorta than those with CAD, as assessed by cfPWV, in part due to higher rates of diabetes. However cfPWV is not prognostic in patients PAD. The lower cfPWV in patients with aortoiliac disease may suggest measurement issues, as this velocity may be decreased because of severe stenosis on the pulse wave trajectory.