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


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Fortier, C, Cote, G, Mac-Way, F, Goupil, R, Desbiens, L-C, Desjardins, M-P, Marquis, K, Hametner, B, Wassertheurer, S, Schultz, MG ORCID: 0000-0003-3458-1811, Sharman, JE ORCID: 0000-0003-2792-0811 and Agharazii, M 2019 , 'Prognostic value of carotid and radial artery reservoir-wave parameters in end-stage renal disease' , Journal of the American Heart Association, vol. 8, no. 13 , pp. 1-11 , doi: 10.1161/JAHA.119.012314.

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Background: Reservoir-wave approach is an alternative model of arterial hemodynamics based on the assumption that measured arterial pressure is composed of volume-related (reservoir pressure) and wave-related components (excess pressure). However, the clinical utility of reservoir-wave approach remains debatable.Methods and Results: In a single-center cohort of 260 dialysis patients, we examined whether carotid and radial reservoir-wave parameters were associated with all-cause and cardiovascular mortality. Central pulse pressure and augmentation index at 75 beats per minute were determined by radial arterial tonometry through generalized transfer function. Carotid and radial reservoir-wave analysis were performed to determine reservoir pressure and excess pressure integral. After a median follow-up of 32 months, 171 (66%) deaths and 88 (34%) cardiovascular deaths occurred. In Cox regression analysis, carotid excess pressure integral was associated with a hazard ratio of 1.33 (95% CI , 1.14-1.54; PPP=0.004) and cardiovascular mortality (hazard ratio per 1 SD, 1.31; 95% CI : 1.04-1.63; P=0.019). Conversely, there were no significant associations between radial reservoir-wave parameters, central pulse pressure, augmentation index at 75 beats per minute, pressure forward, pressure backward and reflection magnitude, and all-cause or cardiovascular mortality after adjustment for comorbidities.Conclusions: These observations support the clinical value of reservoir-wave approach parameters of large central elastic vessels in end-stage renal disease.

Item Type: Article
Authors/Creators:Fortier, C and Cote, G and Mac-Way, F and Goupil, R and Desbiens, L-C and Desjardins, M-P and Marquis, K and Hametner, B and Wassertheurer, S and Schultz, MG and Sharman, JE and Agharazii, M
Keywords: aortic stiffness, end‐stage renal disease, excess pressure, pulse wave analysis, pulse wave velocity, wave separation analysis
Journal or Publication Title: Journal of the American Heart Association
Publisher: Wiley-Blackwell Publishing, Inc.
ISSN: 2047-9980
DOI / ID Number: 10.1161/JAHA.119.012314
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Copyright 2019 the authors. Licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

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