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Titolo:
Impact of aortic stiffness on survival in end-stage renal disease
Autore:
Blacher, J; Guerin, AP; Pannier, B; Marchais, SJ; Safar, ME; London, GM;
Indirizzi:
Hop Broussais, Med Serv, F-75674 Paris, France Hop Broussais Paris France F-75674 sais, Med Serv, F-75674 Paris, France Hop FH Manhes, Fieury Merogis, France Hop FH Manhes Fieury Merogis France p FH Manhes, Fieury Merogis, France
Titolo Testata:
CIRCULATION
fascicolo: 18, volume: 99, anno: 1999,
pagine: 2434 - 2439
SICI:
0009-7322(19990511)99:18<2434:IOASOS>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR HYPERTROPHY; CAROTID-ARTERY STIFFNESS; DIASTOLIC BLOOD-PRESSURE; ISCHEMIC-HEART-DISEASE; MAINTENANCE HEMODIALYSIS; CARDIOVASCULAR-DISEASE; RISK; ATHEROSCLEROSIS; MORTALITY; DIALYSIS;
Keywords:
aorta; survival; kidney;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: London, GM CH Manhes, 8 Grande Rue, F-91712 Ste Genevieve Des Bois, FranceCH Manhes 8 Grande Rue Ste Genevieve Des Bois France F-91712 e
Citazione:
J. Blacher et al., "Impact of aortic stiffness on survival in end-stage renal disease", CIRCULATION, 99(18), 1999, pp. 2434-2439

Abstract

Background-Damage to large arteries is a major factor in the high cardiovascular morbidity and mortality of patients with end-stage renal disease (ESRD). Increased arterial stiffness and intima-media thickness, together withincreased pulse pressure, are the principal arterial alterations. Whether increased aortic pulse-wave velocity (PWV), a classic marker of increased arterial stiffness, may predict all-cause and/or cardiovascular mortality has never been investigated. Methods and Results-A cohort of 241 patients with ESRD undergoing hemodialysis was studied between April 1987 and April 1998. The mean duration of follow-up was 72+/-41 months (mean+/-SD). Mean age at entry was 51.5+/-16.3 years. Seventy-three deaths occurred, including 48 cardiovascular and 25 noncardiovascular fatal events. At entry, together with standard clinical and biochemical analyses, patients underwent echocardiography and aortic PWV measured by Doppler ultrasonography, On the basis of Cox analyses, 2 factors emerged as predictors of all-cause and cardiovascular mortality: age and aortic PWV. Hemoglobin and low diastolic pressure interfered to a smaller extent. After adjustment for all the confounding factors, an OR for PWV >12.0 versus <9.3 m/s was 5.3 (95% CI, 2.4 to 11.9) for all-cause mortality and 5.9 (95% CI, 2.3 to 15.5) for cardiovascular mortality. For each PWV increase of 1 m/s in our study population, all-cause mortality-adjusted OR was 1.39 (95% CI, 1.19 to 1.62),Conclusions-These results provide the first direct evidence that in patients with ESRD, increased aortic stiffness determined by measurement of aortic PWV is a strong independent predictor of all-cause and mainly cardiovascular mortality.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 22:16:33