Aortic Stiffness and Central Wave Reflections Predict Outcome in Renal Transplant Recipients
| Autor: | Wim Van Biesen, Michel Jadoul, Raymond Vanholder, Steven Van Laecke, Luc M. Van Bortel, Céline Maréchal, Olivier Devuyst, Francis Verbeke |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Graft Rejection
Male medicine.medical_treatment Blood Pressure augmentation index DISEASE Cohort Studies Postoperative Complications Belgium DIALYSIS Medicine and Health Sciences Medicine Pulse wave velocity Academic Medical Centers Graft Survival Hazard ratio augmentation pressure Middle Aged Prognosis Survival Rate Treatment Outcome Cardiovascular Diseases Cohort SURVIVAL Cardiology Female Aortic stiffness ARTERIAL STIFFNESS kidney medicine.medical_specialty pulse wave velocity ALL-CAUSE PRESSURE Risk Assessment cardiovascular events Vascular Stiffness Predictive Value of Tests Internal medicine Internal Medicine Humans Dialysis Proportional Hazards Models Retrospective Studies Receiver operating characteristic business.industry MORTALITY VELOCITY medicine.disease Kidney Transplantation Surgery Transplantation Multivariate Analysis Arterial stiffness Kidney Failure Chronic business transplantation |
| Zdroj: | HYPERTENSION |
| ISSN: | 1524-4563 0194-911X |
| Popis: | Although renal transplantation improves survival, cardiovascular morbidity and mortality remain significantly elevated compared with nonrenal populations. The negative impact of traditional, uremia-related, and transplantation-related risk factors in this process remains, however, largely unexplored. Surrogate markers such as aortic stiffness and central wave reflections may lead to more accurate cardiovascular risk stratification, but outcome data in renal transplant recipients are scarce. We aimed to establish the prognostic significance of these markers for fatal and nonfatal cardiovascular events in renal transplant recipients. Carotid-femoral pulse wave velocity, central augmentation pressure, and central augmentation index were measured in a cohort of 512 renal transplant recipients using the SphygmoCor system. After a mean follow-up of 5 years, 20 fatal and 75 nonfatal cardiovascular events were recorded. Using receiver operating characteristic curves, the area under the curve for predicting cardiovascular events was 0.718 (95% CI 0.659–0.776) for pulse wave velocity, 0.670 (95% CI 0.604–0.736) for central augmentation pressure, and 0.595 (95% CI 0.529–0.660) for central augmentation index. When we accounted for age, gender, and C-reactive protein in Cox-regression analysis, pulse wave velocity (hazard ratio: 1.349 per 1 SD increase; 95% CI 1.104–1.649; P =0.003) and central augmentation pressure (hazard ratio: 1.487 per 1 SD increase; 95% CI 1.219–1.814; P |
| Databáze: | OpenAIRE |
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