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Titolo:
CARDIAC AND ARTERIAL INTERACTIONS IN END-STAGE RENAL-DISEASE
Autore:
LONDON GM; GUERIN AP; MARCHAIS SJ; PANNIER B; SAFAR ME; DAY M; METIVIER F;
Indirizzi:
HOP MANHES,SERV NEPHROL HEMODIALYSE,8 GRANDE RUE F-91700 FLEURY MEROGIS FRANCE INSERM,U337 PARIS FRANCE JOHN HUNTER HOSP,DEPT ANAESTHESIA & INTENS CARE NEWCASTLE NSW AUSTRALIA
Titolo Testata:
Kidney international
fascicolo: 2, volume: 50, anno: 1996,
pagine: 600 - 608
SICI:
0085-2538(1996)50:2<600:CAAIIE>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
WAVE REFLECTIONS; CAROTID-ARTERY; CHRONIC UREMIA; PRESSURE; HYPERTENSION; DISTENSIBILITY; HEMODIALYSIS; HYPERTROPHY; DIALYSIS; FLOW;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
43
Recensione:
Indirizzi per estratti:
Citazione:
G.M. London et al., "CARDIAC AND ARTERIAL INTERACTIONS IN END-STAGE RENAL-DISEASE", Kidney international, 50(2), 1996, pp. 600-608

Abstract

Although cardiac hypertrophy is a frequent complication of end-stage renal disease (ESRD), relatively little is known about large arterial geometry and function in vivo in these patients, and the relationship between arterial changes and cardiac hypertrophy is unknown. Common carotid artery (CCA) intima-media thickness and internal diameter and left ventricular geometry and function were determined by ultrasound imaging in 70 uncomplicated ESRD patients and in 50 age-, sex-, and bloodpressure-matched controls. Arterial distensibility and compliance were determined from simultaneously recorded CCA diameter and stroke changes in diameter and CCA pressure waveforms, obtained by applanation tonometry, and also by the measurement of carotid-femoral pulse wave velocity. Compared with control subjects, ESRD patients had greater left ventricular diameter (P < 0.01), wall thicknesses and mass (P < 0.001), increased CCA diameter (6.25 +/- 0.87 vs 5.55 +/- 0.65 mm; P < 0.001), larger CCA intima-media thickness (777 +/- 115 vs. 678 +/- 105 mu m; P < 0.001) and intima-media cross-sectional area (17.5 +/- 4.5 vs. 13.4 +/- 3.3 mm(2); P < 0.001). In uremic patients, arterial hypertrophy was associated with decreased CCA distensibility (17.8 +/- 8.8 vs. 24.0 +/- 12.7 kPa(-1) . 10(-5); P < 0.001) and compliance (5.15 +/- 2 vs. 6.0 +/- 2.5 m(2) . kPa(-1) . 10(-7); P < 0.05), accelerated carotid-femoral pulse wave velocity (1055 +/- 290 vs. 957 +/- 180 cm/seconds;P < 0.001), early return and increased effect of arterial wave reflections (20.5 +/- 15.4 vs. 9.2 +/- 18.4%; P < 0.001). The latter phenomenons were responsible for increased pulsatile pressure load in CCA (58.3 +/- 21 vs. 48 +/- 17 mm Hg; P < 0.01) and were associated with a decreased subendocardial viability index (157 +/- 31 vs. 173 +/- 30%; P < 0.001). The CCA diameter was correlated with the left ventricular diameter (P < 0.01), and a significant correlations existed between CCA wail thickness or CCA intima-media cross-sectional area and left ventricular wall thicknesses and/or left ventricular mass (P < 0.01). Ln multivariate analysis, these relationships were independent regarding age,sex, blood pressure and body surface area. The presents study documents parallel cardiac and vascular adaptation in ESRD, and demonstratesthe potential contribution of structural and functional large artery alterations to the pathogenesis of left ventricular hypertrophy and functional alterations.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/11/20 alle ore 22:51:17