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Wu R, Zhou S, Liu M, An H, Wang Z, Liu T. Clinical Significance of miR-21-5p in Predicting Occurrence and Progression of Uremic Vascular Calcification in Patients with End-Stage Renal Disease. Yonsei Med J 2022; 63:252-258. [PMID: 35184427 PMCID: PMC8860934 DOI: 10.3349/ymj.2022.63.3.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/29/2021] [Accepted: 11/12/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Vascular calcification (VC) is a common complication of end-stage renal disease (ESRD). This study aimed to examine changes in the expression of miR-21-5p in ESRD patients with VC and to explore its clinical value in predicting the occurrence and progression of uremic VC. MATERIALS AND METHODS 120 ESRD patients were divided into patients without VC group (n=38) and patients with VC group (n=82). All patients were followed up for 2 years to evaluate VC progression. qRT-PCR was used to detect serum miR-21-5p levels. Receiver operating characteristic curves were constructed to assess diagnostic value. Kaplan-Meier and log-rank methods were utilized to calculate associations between VC progression and risk factors. RESULTS Serum miR-21-5p levels were significantly higher in ESRD patients with VC than in those without VC and increased progressively with increasing disease severity. Serum miR-21-5p levels were able to distinguish patients with VC from those without VC, with an area under the curve value of 0.883, a sensitivity of 81.7%, and a specificity of 84.2%. After 2 years of follow-up, miR-21-5p expression had increased in patients with worse VC severity, compared with those with stable VC severity. Patients with high miR-21-5p levels were more likely to develop more severe VC, indicating an association between miR-21-5p and VC progression (log-rank p=0.002). Multivariable Cox regression analysis suggested that serum miR-21-5p is an independent predictive factor of VC progression in ESRD patients (hazard ratio=2.064, 95% confidence interval=1.225-3.478, p=0.006). CONCLUSION miR-21-5p is overexpressed in the serum of ESRD patients with VC. Our results suggest that overexpression of miR-21-5p is closely associated with VC progression.
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Affiliation(s)
- Rong Wu
- Department of Nephropathy, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Sen Zhou
- Department of Nephropathy, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Minglong Liu
- Department of Nephropathy, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Haiqian An
- Department of Nephropathy, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Zhe Wang
- Department of Nephropathy, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Tianxi Liu
- Department of Nephropathy, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
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Fortier C, Garneau CA, Paré M, Obeid H, Côté N, Duval K, Goupil R, Agharazii M. Modulation of Arterial Stiffness Gradient by Acute Administration of Nitroglycerin. Front Physiol 2021; 12:774056. [PMID: 34975528 PMCID: PMC8715004 DOI: 10.3389/fphys.2021.774056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Physiologically, the aorta is less stiff than peripheral conductive arteries, creating an arterial stiffness gradient, protecting microcirculation from high pulsatile pressure. However, the pharmacological manipulation of arterial stiffness gradient has not been thoroughly investigated. We hypothesized that acute administration of nitroglycerin (NTG) may alter the arterial stiffness gradient through a more significant effect on the regional stiffness of medium-sized muscular arteries, as measured by pulse wave velocity (PWV). The aim of this study was to examine the differential impact of NTG on regional stiffness, and arterial stiffness gradient as measured by the aortic-brachial PWV ratio (AB-PWV ratio) and aortic-femoral PWV ratio (AF-PWV ratio). Methods: In 93 subjects (age: 61 years, men: 67%, chronic kidney disease [CKD]: 41%), aortic, brachial, and femoral stiffnesses were determined by cf-PWV, carotid-radial (cr-PWV), and femoral-dorsalis pedis artery (fp-PWV) PWVs, respectively. The measurements were repeated 5 min after the sublingual administration of NTG (0.4 mg). The AB-PWV and AF-PWV ratios were obtained by dividing cf-PWV by cr-PWV or fp-PWV, respectively. The central pulse wave profile was determined by radial artery tonometry through the generalized transfer function. Results: At baseline, cf-PWV, cr-PWV, and fp-PWV were 12.12 ± 3.36, 9.51 ± 1.81, and 9.71 ± 1.89 m/s, respectively. After the administration of NTG, there was a significant reduction in cr-PWV of 0.86 ± 1.27 m/s (p < 0.001) and fp-PWV of 1.12 ± 1.74 m/s (p < 0.001), without any significant changes in cf-PWV (p = 0.928), leading to a significant increase in the AB-PWV ratio (1.30 ± 0.39 vs. 1.42 ± 0.46; p = 0.001) and AF-PWV ratio (1.38 ± 0.47 vs. 1.56 ± 0.53; p = 0.001). There was a significant correlation between changes in the AF-PWV ratio and changes in the timing of wave reflection (r = 0.289; p = 0.042) and the amplitude of the heart rate-adjusted augmented pressure (r = − 0.467; p < 0.001). Conclusion: This study shows that acute administration of NTG reduces PWV of muscular arteries (brachial and femoral) without modifying aortic PWV. This results in an unfavorable profile of AB-PWV and AF-PWV ratios, which could lead to higher pulse pressure transmission into the microcirculation.
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Affiliation(s)
- Catherine Fortier
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
- Research Center of the Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - Charles-Antoine Garneau
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Mathilde Paré
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Hasan Obeid
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
| | - Nadège Côté
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Karine Duval
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
| | - Rémi Goupil
- Research Center of the Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - Mohsen Agharazii
- CHU de Québec Research Center-Université Laval, L’Hôtel-Dieu de Québec Hospital, Québec, QC, Canada
- Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada
- *Correspondence: Mohsen Agharazii,
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Korogiannou M, Xagas E, Marinaki S, Sarafidis P, Boletis JN. Arterial Stiffness in Patients With Renal Transplantation; Associations With Co-morbid Conditions, Evolution, and Prognostic Importance for Cardiovascular and Renal Outcomes. Front Cardiovasc Med 2019; 6:67. [PMID: 31179288 PMCID: PMC6543273 DOI: 10.3389/fcvm.2019.00067] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/07/2019] [Indexed: 12/12/2022] Open
Abstract
Patients with chronic kidney disease (CKD), particularly those with end-stage renal disease (ESRD), are at increased risk of cardiovascular events and mortality. The spectrum of arterial remodeling in CKD and ESRD includes atheromatosis of middle-sized conduit arteries and, most importantly, the process of arteriosclerosis, characterized by increased arterial stiffness of aorta and the large arteries. Longitudinal studies showed that arterial stiffness and abnormal wave reflections are independent cardiovascular risk factors in several populations, including patients with CKD and ESRD. Kidney transplantation is the treatment of choice for patients with ESRD, associated with improved survival and better quality of life in relation to hemodialysis or peritoneal dialysis. However, cardiovascular mortality in transplanted patients remains much higher than that in general population, a finding that is at least partly attributed to adverse lesions in the vascular tree of these patients, generated during the progression of CKD, which do not fully reverse after renal transplantation. This article attempts to provide an overview of the field of arterial stiffness in renal transplantation, discussing in detail available studies on the degree and the associations of arterial stiffness with other co-morbidities in renal transplant recipients, the prognostic significance of arterial stiffness for cardiovascular events, renal events and mortality in these individuals, as well as studies examining the changes in arterial stiffness following renal transplantation.
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Affiliation(s)
- Maria Korogiannou
- Department of Nephrology and Renal Transplantation Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Xagas
- Department of Nephrology and Renal Transplantation Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Smaragdi Marinaki
- Department of Nephrology and Renal Transplantation Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Pantelis Sarafidis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - John N Boletis
- Department of Nephrology and Renal Transplantation Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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