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Vyas P, Vadodariya J, Kalsariya V, Patel I, Dake R, Parwani K. Predictive role of novel echocardiographic parameter aortic velocity propagation, QRISK3 and Framingham risk score for presence and severity of CAD in Asian patients. J Cardiovasc Thorac Res 2022; 14:153-158. [DOI: 10.34172/jcvtr.2022.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 06/01/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction: Despite having clinical relevance, arterial stiffness is neglected and not routinely used parameter for evaluation of atherosclerosis. This study aimed to investigate the predictive role of simple non-invasive echocardiographic index of aortic stiffness aortic velocity propagation (AVP), Framingham risk score (FHS) and QRISK3 score for presence and severity of CAD. Methods: This cross-sectional comparative study included 250 patients who required conventional coronary angiogram for stable CAD. The relationship of AVP, FHS and QRISK3 score with CAD were evaluated using spearman’s correlation, logistic regression analysis and ROC curve. Results: On logistic regression analysis, AVP, FHS and QRISK3 were found significant predictors for the presence and severity of CAD. Inverse correlation between AVP and presence of CAD, number of coronary vessels involved and severity of CAD was observed with P=0.001. AVP value≤78 cm/s predicted presence of CAD with 86.4% sensitivity and 84.6% specificity (P≤0.0001, AUC=0.948) and≤39 cm/s predicted severe CAD (Syntax score>22) with 66.7% sensitivity and 97.9% specificity (P≤0.0001, AUC=0.868). FHS value>10 predicted the presence of CAD with a sensitivity of 33.9% and specificity of 91 % (P=0.01, AUC=0.644). QRISK3value>13.4 predicted presence of CAD with 57.1% sensitivity and 87% specificity (P≤0.0001, AUC=0.788). Conclusion: Arterial stiffness parameter AVP is inversely associated with the presence and severity of CAD. AVP and QRISK3 score may be used as a simple bedside tool for risk stratification of patients suspected of having atherosclerotic CAD.
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Affiliation(s)
- Pooja Vyas
- Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
| | - Jaykumar Vadodariya
- Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
| | - Vijay Kalsariya
- Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
| | - Iva Patel
- Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
| | - Radhakisan Dake
- Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
| | - Kunal Parwani
- Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
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Bakirci EM, Degirmenci H, Duman H, Demirelli S, Hamur H, Buyuklu M, Ceyhun G, Kutlusoy E. Aortic propagation velocity in the prediction of coronary artery disease severity. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021; 166:51-56. [PMID: 33612836 DOI: 10.5507/bp.2021.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 01/07/2021] [Indexed: 11/23/2022] Open
Abstract
AIMS To investigate the association of the aortic propagation velocity (APV) with coronary artery disease (CAD) in patients with stable angina pectoris (SAP) through SYNTAX scores (SS). METHODS The study population comprised 214 SAP subjects who received a coronary angiography. The APV and carotid intima-media thickness (CIMT) were examined and SS was calculated. Subjects were grouped following specific SS criteria: SS less than 22 (low) and SS greater than or equal to 22 (high). RESULTS High SS subjects had lower APV compared to low SS [39.0 (32.0-51.7) vs. 55.0 (45.0-62.0) cm/s, respectively; P<0.001] and higher CIMT (0.86 ± 0.24 vs. 0.74 ± 0.21 mm, respectively; P<0.001). APV demonstrated a negative correlation with the CIMT (r=-0.239, P<0.001), age (r=-0.188, P=0.006) , and SS (r=-0.561, P <0.001) and showed a positive association with LV ejection fraction (r=0.163, P=0.017). APV, CIMT, diabetes, low-density lipoprotein cholesterol (LDL-C), and age were determined to be markers independently of a high SS. CONCLUSION APV, CIMT, diabetes, LDL-C and age are independently linked to the CAD severity of SAP subjects. Decreased APV, an indicator of subclinical atherosclerosis, may independently help determine the severity of atherosclerotic CAD in SAP patients.
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Affiliation(s)
- Eftal Murat Bakirci
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Husnu Degirmenci
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Hakan Duman
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Selami Demirelli
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Hikmet Hamur
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Mutlu Buyuklu
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Gokhan Ceyhun
- Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Ergun Kutlusoy
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
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Chen Y, Huang D, Liu J, Zeng F, Tang G, Lei W, Wang H, Jiang Y, Shentu W, Wang H. Non-Invasive Detection of Fetal Vascular Endothelial Function in Gestational Diabetes Mellitus. Front Endocrinol (Lausanne) 2021; 12:763683. [PMID: 34777257 PMCID: PMC8586207 DOI: 10.3389/fendo.2021.763683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/07/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES Endothelial dysfunction in the fetuses of women with gestational diabetes mellitus (GDM) is associated with their subsequent cardiovascular events. Prenatal assessment of endothelial function in fetuses exposed to intrauterine hyperglycemic environment remains challenging. The aim of this study was to assess the fetal vascular endothelial function in GDM patients using color M-mode derived aortic propagation velocity (APV) and evaluate the correlation of APV with endothelial function biomarkers. METHODS This observational cross-sectional study included 31 gestational diabetic mothers and 30 healthy pregnant mothers from August 2019 to January 2020. Clinical data were compared between the groups. Fetal APV was measured using color M-mode echocardiography at late gestation. Concentrations of endothelial biomarkers including von Willebrand Factor (vWF), vascular endothelial-cadherin and endothelin-1 in umbilical cord serum were assessed. Measurements between diabetic group and controls were compared. RESULTS vWF was the only endothelial functional marker that differed between the two groups. Fetuses in the GDM group had significantly lower APV levels and higher vWF levels compared with the healthy controls (P < 0.05). There was a moderate but significant correlation between APV and vWF (r =-0.58, P < 0.001). There were no associations between APV and ventricular wall thickness or umbilical artery pulsatility index. CONCLUSIONS Color M-mode propagation velocity of aorta is a non-invasive, practical method that correlates well with GDM and fetal endothelial function. This novel metric could contribute to recognizing early vascular functional alterations and hence represents a potential strategy for early risk factor surveillance and risk modification.
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Affiliation(s)
- Yunyu Chen
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Danping Huang
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jinrong Liu
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Fangling Zeng
- Institute of Perinatal Nutrition, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Guoyi Tang
- Institute of Obstetrics and Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wenjia Lei
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Haiyu Wang
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yanmin Jiang
- Institute of Obstetrics and Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Weihui Shentu
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Weihui Shentu, ; Hongying Wang,
| | - Hongying Wang
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Weihui Shentu, ; Hongying Wang,
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Association between coronary artery disease severity and videocapillaroscopic findings of nail fold capillary circulation. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.683083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ghaderi F, Samim H, Keihanian F, Danesh Sani SA. The predictive role of aortic propagation velocity for coronary artery disease. BMC Cardiovasc Disord 2018; 18:121. [PMID: 29914383 PMCID: PMC6006674 DOI: 10.1186/s12872-018-0854-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 06/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is well recognized that cardio- vascular risk factors lead to histological and functional changes in aorta, and aortic stiffness is the best predictor of cardiovascular morbidity and mortality. In this study we evaluated the relation of a less evaluated echocardiographic parameter of aortic stiffness, aortic propagation velocity (APV) with the presence and severity of CAD. METHODS This cross sectional study was conducted from May 2015 to March 2016 in Imam Reza hospital, Mashhad, Iran. Seventy patients who were referred for elective coronary artery angiography were enrolled. Patients were divided into two sub-groups based on angiographic findings: patients with CAD (38 patients, 54.3%) and non-CAD (32 patients, 45.7%). Transthoracic echocardiography was performed using the conventional 2D and color M-Mode imaging. Aortic propagation velocity (APV), aortic strain (AS) and distensibility (AD) were measured. The presence and Severity of CAD (assessing by syntax score) and their relation with aortic stiffness indices were assessed. RESULTS Aortic strain (6.23 ± 1.93% versus 11.66 ± 4.86%, P < 0.0001), distensibility (2.46 ± 0.91 vs 5.57 ± 2.25 cm 2 dyn-110-3, P < 0.0001) and APV (48.63 ± 10.31 cm/sec vs 77.75 ± 9.97 cm/s, P < 0.0001) were significantly decreased in CAD group compared with non-CAD group. In our study, APV showed significant inverse relationship with CAD. Based on our results, APV less than 56 cm/sec could be used to predict CAD with sensitivity and specificity of 96.9 and 78.9% respectively. We also found an inverse correlation between APV and severity of CAD. CONCLUSION Aortic strain, AD and APV (a less evaluated echocardiographic index) showed significant inverse correlation with presence and severity of CAD.
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Affiliation(s)
- Fereshteh Ghaderi
- Fellowship in echocardiography, Cardiology Department, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Samim
- Cardiology Resident, Cardiology Department, Faculty of Medicine, Imam Reza and Ghaem Hospitals, Mashhad University of Medical Sciences, Shariati Square, Mashhad, Iran
| | - Faeze Keihanian
- Cardiology Resident, Cardiology Department, Faculty of Medicine, Imam Reza and Ghaem Hospitals, Mashhad University of Medical Sciences, Shariati Square, Mashhad, Iran. .,Clinician Scientist of Cardiology, Pharmaceutical Research Division, Booali Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Seyed Ali Danesh Sani
- General Practitioner, Cardiology department, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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Gitmez M. Investigation of elastic features of aorta and color M-mode flow propagation velocity (APV) of descending aorta in the patients with ischemic and non-ischemic dilated cardiomyopathy. Int J Cardiovasc Imaging 2018; 34:1563-1570. [PMID: 29799064 DOI: 10.1007/s10554-018-1373-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 05/16/2018] [Indexed: 11/27/2022]
Abstract
Aortic flow propagation velocity (APV) is a novel echocardiographic parameter used in coronary artery disease. It has also been used for the evaluation of aortic stiffness. In the present study, APV was measured in patients with ischemic and non-ischemic dilated cardiomyopathy (DCM) and was compared with the parameters of aortic stiffness such as aortic distensibility (AD) and aortic strain (AS). A total of 140 patients who had undergone coronary angiographic imaging were included in the study. Out of these patients, 44 had ischemic DCM, 46 had non-ischemic DCM, and 50 had normal coronary angiography (control group). AS, AD, and APV were calculated echocardiographically. One-way analysis of variance (ANOVA) and the Kruskal-Wallis test were used to compare continuous variables between the groups, while the categorical variables were compared using Pearson's Chi square test. Pearson's correlation test was used to investigate the parameters associated with APV, AS, and AD. Ischemic DCM and non-ischemic DCM groups differed significantly. The comparison of these groups with the control group, in terms of AS, AD, and APV values (ANOVA p < 0.001 for all) also showed a significant difference. APV was found to be significantly correlated with AS (r = 0.645, p < 0.001) and AD (r = 0.604, p < 0.001). In ROC analysis, the area under the curve (AUC) value for APV was 0.999 (p = 0.000) for detection of patients ischemic DCM and non-ischemic DCM. APV may be considered to be a novel and a simple echocardiographic marker, for both, distinguishing ischemic from non-ischemic DCM as well as for the presence of dilated cardiomyopathy with or without critical coronary artery disease.
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Affiliation(s)
- Mesut Gitmez
- Clinic of Cardiology, Batman State Hospital, Batman, Turkey.
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7
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Aortic propagation velocity does not correlate with classical aortic stiffness parameters in healthy individuals. Anatol J Cardiol 2017; 18:340-346. [PMID: 29083326 PMCID: PMC5731283 DOI: 10.14744/anatoljcardiol.2017.7306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: Aortic stiffness is an important cardiovascular risk marker, which can be determined using different noninvasive techniques. Aortic propagation velocity (APV) has recently been established as a novel echocardiographic parameter of aortic stiffness. This study aimed to investigate the association between APV and the classical echocardiography-derived aortic stiffness parameters, aortic distensibility (AD) and aortic strain (AS), in a group of otherwise healthy individuals. Methods: In total, 97 consecutive healthy subjects were recruited in this observational study. APV was measured using color M-mode echocardiography from the suprasternal window in the descending aorta. AS and AD were calculated using clinical blood pressure and the M-mode echocardiography-derived aortic diameters. Correlation analyses were performed between cardiovascular risk factors related to increased aortic stiffness (age, obesity, and blood pressure) and measured stiffness parameters (APV, AS, and AD). Correlation analyses were also performed among the measured stiffness parameters. Results: Good correlation of age, blood pressure, and BMI with AS and AD was observed. One-on-one correlation of age, blood pressure, and BMI with APV was not observed. No correlation was observed between APV and AS (r=–0.05, p=0.6) or between APV and AD (r=–0.17, p=0.8). Conclusion: Although APV has been proposed as a novel and practical echocardiographic parameter of aortic stiffness, especially in patients with coronary artery disease, correlations between classical stiffness parameters (AS and AD) and APV were absent in healthy individuals at low–intermediate risk. The clinical and research applicability of APV should be further evaluated.
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Vasudeva Chetty P, Rajasekhar D, Vanajakshamma V, Ranganayakulu KP, Kranthi Chaithanya D. Aortic velocity propagation: A novel echocardiographic method in predicting atherosclerotic coronary artery disease burden. J Saudi Heart Assoc 2017; 29:176-184. [PMID: 28652671 PMCID: PMC5475356 DOI: 10.1016/j.jsha.2016.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 10/02/2016] [Accepted: 10/13/2016] [Indexed: 11/26/2022] Open
Abstract
Background The major burden of cardiovascular disease mortality around the globe is due to atherosclerosis and its complications. Hence its early detection and management with easily accessible and noninvasive methods are valuable. Aortic velocity propagation (AVP) through color M-mode of the proximal descending aorta determines aortic stiffness, reflecting atherosclerosis. The aim of this study was to find the utility of AVP in predicting coronary artery disease (CAD) burden assessed through SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score and compared with carotid intima-media thickness (CIMT), which is an established surrogate marker of atherosclerosis. Methods In this cross-sectional comparative study, we measured AVP by color M-mode and CIMT by using Philips QLAB-IMT software in 100 patients, who underwent conventional coronary angiogram (CAG) between May 2013 and November 2014. Coronary artery disease is considered significant if >50% diameter stenosis is present in any epicardial coronary artery and insignificant if otherwise. Results Initially, to know the normal range we measured AVP and CIMT in 50 patients without any major risk factors for CAD but CAG was not done. Aortic velocity propagation ranged from 46 cm/s to 76 cm/s (mean = 58.62 ± 6.46 cm/s), CIMT ranged from 0.50 mm to 0.64 mm (mean = 0.55 ± 0.03 mm). Among 100 patients who underwent CAG we found 69% had significant CAD, 13% had insignificant CAD, and 18% had normal coronaries. Those with significant CAD had significantly lower AVP (41.65 ± 4.94 cm/s) [F (2,97) = 44.05, p < 0.0001] and significantly higher CIMT (0.86 ± 0.11 mm) [F (2,97) =35.78, p < 0.0001]. AVP had significant strong negative correlation with CIMT (r = −0.836, p < 0.0001, n = 100) and SYNTAX score (r = –0.803, p < 0.0001, n = 69), while CIMT was positively correlated with SYNTAX score significantly (r = 0.828, p < 0.0001, n = 69). Conclusions AVP and CIMT can predict CAD burden in a robust way. AVP may emerge as an exquisite bedside tool to predict atherosclerotic burden and guide in implementing preventive therapy for cardiovascular disease.
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Affiliation(s)
- Pakala Vasudeva Chetty
- Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, IndiaaIndia
| | - Durgaprasad Rajasekhar
- Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, IndiaaIndia
| | - Velam Vanajakshamma
- Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, IndiaaIndia
| | | | - Dommara Kranthi Chaithanya
- Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, IndiaaIndia
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Yaman M, Arslan U, Bayramoğlu A, Bektaş O, Karataş A. Color M-mode echocardiography-derived propagation velocity of descending aorta decreases with aging. Ther Clin Risk Manag 2017; 13:669-674. [PMID: 28579791 PMCID: PMC5449113 DOI: 10.2147/tcrm.s133011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Arterial stiffness (AS) can be determined by some noninvasive tests such as pulse wave velocity (PWV). Atherosclerosis is also detectable by some ultrasonographic techniques such as color M-mode-derived propagation velocity measured along the origin of the descending aorta (AVP). Aim The aim of the study was to find out a possible relationship between atherosclerosis and AVP and whether AVP can be used as a parameter of AS. Materials and methods The study group was composed of 134 people from routine screening examination who were ≥40 years old, completely healthy, and without any known disease and use of any drug. PWV has been determined to show aortic stiffness, and carotid artery intima– media thickness (CIMT) was measured for subclinical atherosclerosis. AVP values were obtained from all participants, and correlations were calculated between these parameters and age. Results AVP decreased (r=−0.902, P<0.001) and PWV increased (r=0.854, P<0.001) significantly with increasing age. CIMT also increased with aging (r=0.518, P<0.001). There were significant correlations between AVP and PWV (r=−0.832, P<0.001) and AVP and CIMT (r=−0.345, P<0.001). Conclusion Transthoracic echocardiographic determination of AVP can be used as a simple measurement of AS and correlates well with PWV, age, and CIMT in healthy people.
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Affiliation(s)
- Mehmet Yaman
- Cardiology Department, Samsun Training and Research Hospital, Health Sciences University, Samsun.,Cardiology Department
| | - Uğur Arslan
- Cardiology Department, Samsun Training and Research Hospital, Health Sciences University, Samsun
| | | | | | - Ahmet Karataş
- Nephrology Department, Education and Research Hospital, Ordu University, Ordu, Turkey
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Aortic flow propagation velocity, epicardial fat thickness, and osteoprotegerin level to predict subclinical atherosclerosis in patients with nonalcoholic fatty liver disease. Anatol J Cardiol 2016; 16:974-979. [PMID: 27025201 PMCID: PMC5324920 DOI: 10.14744/anatoljcardiol.2016.6706] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objective: Nonalcoholic fatty liver disease is the most common cause of liver dysfunction in Western countries and an independent risk factor for atherosclerotic heart disease. Appropriate noninvasive parameters are lacking for optimal risk stratification of cardiovascular disease in these patients. We evaluated several recently discovered noninvasive parameters for atherosclerosis in patients with nonalcoholic fatty liver disease: epicardial fat thickness, aortic flow propagation velocity, and osteoprotegerin level. Methods: Forty-one patients (27 men and 14 women; mean age, 37.9±8.9 years) with nonalcoholic fatty liver disease and 37 control subjects (17 men and 20 women; mean age, 34.5±8.6 years) were enrolled in this observational case-control study. Patients with nonalcoholic fatty liver disease diagnosed at a gastroenterology outpatient clinic were included. Patients with cardiac pathology other than hypertension were excluded. Epicardial fat thickness and aortic flow propagation velocity were measured by echocardiography. The serum concentration of osteoprotegerin was measured using a commercial enzyme-linked immunosorbent assay kit. Results: Nonalcoholic fatty liver disease patients exhibited a significantly lower aortic flow propagation velocity (155.17±30.00 vs. 179.00±18.14 cm/s, p=0.000) and significantly higher epicardial fat thickness (0.51±0.25 vs. 0.29±0.09 cm, p=0.000) than control subjects. Osteoprotegerin levels were higher, but not significant, in patients with nonalcoholic fatty liver disease (28.0±13.0 vs. 25.2±10.8 pg/mL, p=0.244). Binary logistic regression analysis showed that aortic flow propagation velocity (OR, –0.973; 95% CI, 0.947–0.999) and waist circumference (OR, –1.191; 95% CI, 1.088–1.303) were independent predictors of nonalcoholic fatty liver disease. Conclusion: In this study, epicardial fat thickness and osteoprotegerin level were higher and aortic flow propagation velocity was lower in patients with nonalcoholic fatty liver disease. Early detection of abnormal epicardial fat thickness and aortic flow propagation velocity may warrant a search for undetected cardiovascular disease in patients with nonalcoholic fatty liver disease. (Anatol J Cardiol 2016; 16: 974-9)
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Arterial stiffness in metabolic syndrome. J Saudi Heart Assoc 2016; 28:249-56. [PMID: 27688673 PMCID: PMC5034362 DOI: 10.1016/j.jsha.2015.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 11/05/2015] [Accepted: 12/23/2015] [Indexed: 11/22/2022] Open
Abstract
Arterial stiffness is increasingly recognized as an important determinant of cardiovascular risk and may be directly involved in the process of atherosclerosis. As atherosclerosis leads to increased arterial resistance and decrease the flow propagation speed within the arterial lumen, a similar decrease in aortic flow propagation with increased downstream resistance is detected, so aortic flow propagation velocity AVP was evaluated in many studies as a new parameter of aortic stiffness. Aim To measure arterial stiffness using the new parameter AVP and compare it to flow mediated dilatation FMD as a parameter of endothelial dysfunction in patients with metabolic syndrome MS. Methods AVP (assessed by transthoracic echocardiography) and FMD (assessed by brachial artery reactivity test) were measured in 100 patients with MS (Group 1) and were compared to 14 normal subjects (Group 2). Results Patients with MS had significantly lower values of AVP as compared to the normal subjects; 36 ± 5 cm/s vs 57 ± 5, p < 0.05, and lower FMD; 6% ± 1 vs 17 ± 3 p < 0.05 as well, there was significant correlations between AVP and FMD (r = 0.89, p < 0.001). Conclusion Transthoracic echocardiographic determination of AVP is a simple practical method and correlates well with FMD in patients with MS.
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Key Words
- ALT, alanine transaminase
- AST, aspartate transaminase
- AVP
- AVP, aortic velocity propagation
- Aortic propagation velocity
- Arterial stiffness
- CRP, C reactive protein
- DBP, diastolic blood pressure
- E/e′, filling pressure
- EPF, epicardial fat
- FBS, fasting blood sugar
- FMD, flow mediated dilatation
- HDL, high density lipoprotein
- IVS, interventricular septum
- Metabolic syndrome
- SBP, systolic blood pressure
- TC, total cholesterol
- TG, triglycerides
- UA, uric acid
- WC, waist circumference
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Akdag S, Akyol A, Cakmak HA, Gunbatar H, Asker M, Babat N, Tosu AR, Yaman M, Gumrukcuoglu HA. A Novel Echocardiographic Method for Assessing Arterial Stiffness in Obstructive Sleep Apnea Syndrome. Korean Circ J 2015; 45:500-9. [PMID: 26617653 PMCID: PMC4661366 DOI: 10.4070/kcj.2015.45.6.500] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 03/31/2015] [Accepted: 06/02/2015] [Indexed: 11/20/2022] Open
Abstract
Background and Objectives Obstructive sleep apnea syndrome (OSAS) is associated with increased arterial stiffness and cardiovascular complications. The objective of this study was to assess whether the color M-mode-derived propagation velocity of the descending thoracic aorta (aortic velocity propagation, AVP) was an echocardiographic marker for arterial stiffness in OSAS. Subjects and Methods The study population included 116 patients with OSAS and 90 age and gender-matched control subjects. The patients with OSAS were categorized according to their apnea hypopnea index (AHI) as follows: mild to moderate degree (AHI 5-30) and severe degree (AHI≥30). Aortofemoral pulse wave velocity (PWV), carotid intima-media thickness (CIMT), brachial artery flow-mediated dilatation (FMD), and AVP were measured to assess arterial stiffness. Results AVP and FMD were significantly decreased in patients with OSAS compared to controls (p<0.001). PWV and CIMT were increased in the OSAS group compared to controls (p<0.001). Moreover, AVP and FMD were significantly decreased in the severe OSAS group compared to the mild to moderate OSAS group (p<0.001). PWV and CIMT were significantly increased in the severe group compared to the mild to moderate group (p<0.001). AVP was significantly positively correlated with FMD (r=0.564, p<0.001). However, it was found to be significantly inversely related to PWV (r=-0.580, p<0.001) and CIMT (r=-0.251, p<0.001). Conclusion The measurement of AVP is a novel and practical echocardiographic method, which may be used to identify arterial stiffness in OSAS.
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Affiliation(s)
- Serkan Akdag
- Department of Cardiology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Aytac Akyol
- Department of Cardiology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | | | - Hulya Gunbatar
- Department of Pulmonary Diseas, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Muntecep Asker
- Department of Cardiology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Naci Babat
- Department of Cardiology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Aydin Rodi Tosu
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey
| | - Mehmet Yaman
- Department of Cardiology, Samsun Education and Training Hospital, Samsun, Turkey
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Taşolar H, Taşolar S, Kurtuluş D, Altun B, Bayramoğlu A, Otlu YÖ, Ballı M, Çetin M, Altunışık N, Kapıcıoğlu Y, Pekdemir H. Increased epicardial adipose tissue thickness on transthoracic echocardiography in patients with Behçet disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:1393-1400. [PMID: 25063404 DOI: 10.7863/ultra.33.8.1393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Owing to the fact that the potential frequency of endothelial dysfunction and early atherosclerosis might be higher in Behçet disease, characterized by acute and chronic inflammatory attacks, it may lead to impairment in flow-mediated dilatation and an increase in epicardial adipose tissue thickness. Therefore, we aimed to evaluate whether epicardial adipose tissue thickness and brachial artery flow-mediated dilatation as markers of early atherosclerosis and endothelial dysfunction were associated with Behçet disease. METHODS Thirty-five patients with Behçet disease and 35 healthy volunteers were included in this study. Epicardial adipose tissue was identified as an anechoic space between epicardial layers on 2-dimensional images, and its thickness was measured on the free wall of the right ventricle. Right brachial artery flow-mediated dilatation was assessed according to recent guidelines. RESULTS Serum γ-glutamyl transferase (GGT) levels and epicardial adipose tissue thickness were significantly higher (P = .001; P < .001 respectively), whereas flow-mediated, endothelium-dependent dilatation was significantly lower in the Behçet disease group than controls (P < .001). There was a significant negative association between epicardial adipose tissue thickness and flow-mediated dilatation (P < .001). Epicardial adipose tissue thickness was also positively correlated with Behçet disease activity (P< .001), Behçet disease duration (P< .001), and waist circumference (P< .001). Flow-mediated dilatation was negatively correlated with GGT (P< .001), Behçet disease activity (P< .001), and age (P< .001). There was also a significant association between GGT and Behçet disease activity (P < .001). CONCLUSIONS We found that epicardial adipose tissue thickness was significantly higher and flow-mediated dilatation was significantly lower in patients with Behçet disease than in controls. We suggest that identification of increased epicardial adipose tissue might aid in the diagnosis and treatment of possible coronary artery disease in patients with Behçet disease.
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Affiliation(s)
- Hakan Taşolar
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey.
| | - Sevgi Taşolar
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Duygu Kurtuluş
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Burak Altun
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Adil Bayramoğlu
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Yılmaz Ömür Otlu
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Mehmet Ballı
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Mustafa Çetin
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Nihal Altunışık
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Yelda Kapıcıoğlu
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Hasan Pekdemir
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
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Yurtdaş M, Yaylali YT, Kaya Y, Özdemir M, Özkan İ, Aladağ N. Neutrophil-to-Lymphocyte Ratio May Predict Subclinical Atherosclerosis in Patients with Psoriasis. Echocardiography 2014; 31:1095-104. [DOI: 10.1111/echo.12511] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Mustafa Yurtdaş
- Department of Cardiology; Van Region Training and Research Hospital; Van Turkey
| | - Yalin T. Yaylali
- Department of Cardiology; School of Medicine; Pamukkale University; Denizli Turkey
| | - Yüksel Kaya
- Department of Cardiology; School of Medicine; Kafkas University; Kars Turkey
| | - Mahmut Özdemir
- Department of Cardiology; Van Region Training and Research Hospital; Van Turkey
| | - İlker Özkan
- Department of Dermatology; Lokman Hekim Hospital; Van Turkey
| | - Nesim Aladağ
- Department of Cardiology; Van Region Training and Research Hospital; Van Turkey
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Sahin M, Simsek H, Akyol A, Akdag S, Yaman M, Aydin C, Kul S, Soyoral Y, Gumrukcuoglu HA. A new echocardiographic parameter of arterial stiffness in end-stage renal disease. Herz 2013; 39:749-54. [PMID: 23903361 DOI: 10.1007/s00059-013-3898-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 06/25/2013] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cardiovascular disease is the leading cause of death among patients with end-stage renal disease (ESRD). Arterial stiffness is an independent predictive parameter of overall and cardiovascular mortality in these patients. However, the defined procedures for the measurement of arterial stiffness are time consuming and not practical in daily practice. METHODS The study population included 50 patients with ESRD who were treated with hemodialysis (HD; n=23) or peritoneal dialysis (PD; n=27) and 70 age- and sex-matched control subjects. Aortofemoral pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and color M-mode propagation velocity of the descending aorta (aortic propagation velocity, APV) were measured. RESULTS Compared to the control group, the patients with ESRD had significantly lower APV (46.4 ± 12.4 vs. 58.5 ± 8.5, p < 0.01) and higher PWV (10.5 ± 2.5 vs. 9.2 ± 1.2, p < 0.01) and CIMT (0.66 ± 0.15 vs. 0.43 ± 0.06, p < 0.01) measurements. There were significant correlations between APV and CIMT (r = - 0.769, p < 0.001), APV and PWV (r = - 0.682, p < 0.001), and PWV and CIMT (r = 0.564, p < 0.001). There were no significant differences in APV and PWV between the PD and HD patients. CONCLUSION Arterial stiffness is an important indicator of atherosclerosis and arterial aging in patients with ESRD. The measurement of APV is an easy and practical new echocardiographic method and may be used to identify arterial stiffness in these patients.
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Affiliation(s)
- M Sahin
- Faculty of Medicine, Department of Cardiology, Yuzuncu Yil University, Van, Turkey,
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Simsek H, Sahin M, Gunes Y, Dogan A, Gumrukcuoglu HA, Tuncer M. A Novel Echocardiographic Method for the Detection of Subclinical Atherosclerosis in Newly Diagnosed, Untreated Type 2 Diabetes. Echocardiography 2013; 30:644-8. [DOI: 10.1111/echo.12125] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Hakki Simsek
- Cardiology Department; Yuzunci Yil University; Faculty of Medicine; Van; Turkey
| | - Musa Sahin
- Cardiology Department; Yuzunci Yil University; Faculty of Medicine; Van; Turkey
| | - Yilmaz Gunes
- Cardiology Department; Hisar Intercontinental Hospital; Istanbul; Turkey
| | - Adnan Dogan
- Cardiology Department; Dumlupinar University; Faculty of Medicine; Kutahya; Turkey
| | | | - Mustafa Tuncer
- Cardiology Department; Yuzunci Yil University; Faculty of Medicine; Van; Turkey
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17
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Khaira A, Mahajan S, Kumar A, Saraya A, Tiwari SC, Prakash S, Gupta A, Bhowmik D, Agarwal SK. Endothelial function and oxidative stress in chronic kidney disease of varying severity and the effect of acute hemodialysis. Ren Fail 2011; 33:411-7. [PMID: 21529270 DOI: 10.3109/0886022x.2011.568138] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM Oxidative stress (OS) and endothelial dysfunction are implicated in accelerated atherosclerosis in chronic kidney disease (CKD). We assessed endothelial function, OS, and carotid intimal medial thickness (CIMT) and their correlates in 44 CKD stage 5 patients (group III) before and after hemodialysis (HD), 40 patients of CKD stages 3 and 4 (group II), and 25 matched controls (group I). METHODS OS was measured by serum concentration of antioxidants; vitamin C and fractional reducing ability of plasma (FRAP) and pro-oxidant; thiobarbituric acid reactive substances (TBARS). Ultrasonography of carotid artery for CIMT and of brachial artery for flow-mediated dilatation (endothelium-dependent dilatation, EDD) was done. RESULTS TBARS increased significantly with severity of CKD. Antioxidants FRAP and vitamin C were significantly lower in CKD patients as compared with controls, but there was no significant difference between groups II and III. EDD decreased significantly with severity of CKD, whereas CIMT though higher in CKD patients as compared with controls was not significantly different between groups II and III. After a session of HD as compared with predialysis, levels of TBARS decreased, whereas those of FRAP, vitamin C, and EDD increased. On multivariate analysis, there was negative correlation of TBARS with glomerular filtration rate (GFR), serum albumin, hemoglobin, and EDD. Vitamin C had positive correlations with GFR, serum albumin, hemoglobin, and EDD. EDD had direct correlation with GFR, whereas CIMT correlated negatively with EDD. CONCLUSIONS Endothelial dysfunction and OS occur early in CKD, are closely related to each other and structural atherosclerosis, and are proportional to decline in GFR.
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Affiliation(s)
- Ambar Khaira
- Department of Nephrology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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