Augmentation index, a predictor of cardiovascular events, is increased in children and adolescents with primary nephrotic syndrome.

Autor: Alves C; Medical Sciences Faculty of Minas Gerais, Post-Graduation Program in Health Sciences, Belo Horizonte, MG, Brazil.; University Hospital of Medical Sciences, Belo Horizonte, MG, Brazil., Pinho JF; Medical Sciences Faculty of Minas Gerais, Post-Graduation Program in Health Sciences, Belo Horizonte, MG, Brazil., Dos Santos LM; Medical Sciences Faculty of Minas Gerais, Post-Graduation Program in Health Sciences, Belo Horizonte, MG, Brazil., Magalhães G; Medical Sciences Faculty of Minas Gerais, Post-Graduation Program in Health Sciences, Belo Horizonte, MG, Brazil., da Silva JM; University Hospital of Medical Sciences, Belo Horizonte, MG, Brazil., Fontes FL; Department of Pediatrics, Pediatric Nephrourology Unit, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil., Caligiorne SM; Mental Health Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil., Pinheiro S; Department of Pediatrics, Pediatric Nephrourology Unit, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil., Rodrigues-Machado MG; Medical Sciences Faculty of Minas Gerais, Post-Graduation Program in Health Sciences, Belo Horizonte, MG, Brazil. maria.machado@cienciasmedicasmg.edu.br.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2020 May; Vol. 35 (5), pp. 815-827. Date of Electronic Publication: 2019 Dec 16.
DOI: 10.1007/s00467-019-04434-0
Abstrakt: Background: Arterial stiffness is associated with an increased risk of cardiovascular diseases. Augmentation index (AIx@75), a measure of arterial stiffness and wave reflection, has not been evaluated in patients with primary nephrotic syndrome (PNS). We investigated whether central and peripheral vascular profiles, hemodynamic parameters, and biochemical tests are associated with AIx@75 in PNS patients.
Methods: This observational study involved 38 children and adolescents with PNS (12.14 ± 3.65 years) and 37 healthy controls (13.28 ± 2.80 years). Arterial stiffness and vascular and hemodynamic parameters were measured noninvasively using the Mobil-O-Graph® (IEM, Stolberg, Germany). In the PNS group, biochemical tests and corticosteroid dosage/treatment time were analyzed.
Results: Peripheral and central systolic blood pressure (SBPp, SBPc) Z-scores were significantly higher in the PNS patients. AIx@75 was significantly higher in the PNS patients (25.14 ± 9.93%) than in controls (20.84 ± 7.18%). In the control group, AIx@75 negatively correlated with weight (r = - 0.369; p = 0.025), height (r = - 0.370; p = 0.024), and systolic volume/body surface (r = - 0.448; p = 0.006). In the PNS group, a univariate linear correlation showed that AIx@75 negatively correlated with weight (r = - 0.360; p = 0.027), height (r = 0.381; p = 0.18), and systolic volume/body surface (r = - 0.447; p < 0.002) and positively with the Z-score of SBPp (r = 0.407; p = 0.011), peripheral diastolic blood pressure (DBPp, r = 0.452; p = 0.004), SBPc (r = 0.416; p = 0.009), DBPc (r = 0.407; p = 0.011), triglycerides (r = 0.525; p = 0.001), and cholesterol [total (r = 0.539; p < 0.001), LDLc (r = 0.420; p = 0.010), and non-HDLc (r = 0.511; p = 0.001)].
Conclusions: Early abnormalities of AIx@75 and vascular parameters suggest that patients with PNS, even in stable condition, present subclinical indicators for the development of cardiovascular disease.
Databáze: MEDLINE
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