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Titolo:
Postischemic vasodilation, endothelial activation, and cardiovascular remodeling in end-stage renal disease
Autore:
Pannier, B; Guerin, AP; Marchais, SJ; Metivier, F; Safar, ME; London, GM;
Indirizzi:
Hop Manhes, Serv Nephrol Hemodialyse, F-91712 Fleury Merogis, Ste Genevieve D, France Hop Manhes Fleury Merogis Ste Genevieve D France F-91712 evieve D, France Hop Broussais, Serv Med Interne, F-75674 Paris, France Hop Broussais Paris France F-75674 rv Med Interne, F-75674 Paris, France
Titolo Testata:
KIDNEY INTERNATIONAL
fascicolo: 3, volume: 57, anno: 2000,
pagine: 1091 - 1099
SICI:
0085-2538(200003)57:3<1091:PVEAAC>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
NITRIC-OXIDE; CORONARY-ARTERY; RISK-FACTORS; DEPENDENT VASODILATATION; MAINTENANCE HEMODIALYSIS; VENTRICULAR HYPERTROPHY; PLASMINOGEN-ACTIVATOR; DIALYSIS PATIENTS; CONDUIT ARTERIES; FAILURE;
Keywords:
cardiac hypertrophy; arteriosclerosis; endothelium; renal failure; hyperemia uremia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
51
Recensione:
Indirizzi per estratti:
Indirizzo: London, GM Hop Manhes, Serv Nephrol Hemodialyse, 8 Grande Rue, F-91712 Fleury Merogis, Ste Genevieve D, France Hop Manhes 8 Grande Rue Fleury MerogisSte Genevieve D France F-91712
Citazione:
B. Pannier et al., "Postischemic vasodilation, endothelial activation, and cardiovascular remodeling in end-stage renal disease", KIDNEY INT, 57(3), 2000, pp. 1091-1099

Abstract

Background. Cardiovascular complications are the major cause of death in end-stage renal disease (ESRD) patients. These complications are associated with concomitant cardiac and vascular remodeling, including left ventricular (LV) hypertrophy and hypertrophy of arterial walls. The endothelium influences the process of arterial remodeling. ESRD patients are characterized by the development of both cardiovascular remodeling and endothelial dysfunction. Methods. Common carotid artery (CCA) intima-media thickness (IMT), CCA diameter, CCA distensibility, LV mass, and function were determined in 60 stable ESRD patients on hemodialysis and 34 age-, sex-, and blood pressure (BP)-matched controls, and their relationships with endothelial alterations were estimated by forearm postischemic vasodilation [flow debt repayment (FDR)] measured by venous plethysmography. We also evaluated th: relationships between FDR and several cardiovascular risk factors or markers of inflammatory response or endothelial activation, for example, duration of dialysis, BP, smoking habits, cholesterol, parathormone (PTH), serum albumin, plasma fibrinogen, C-reactive protein (CRP), plasma homocysteine, plasminogen activator inhibitor (PAI-1), and von Willebrand factor (VWF). Results. ESRD patients had increased LV mass, CCA diameter and CCA IMT, and had decreased CCA distensibility (P < 0.05). While the postischemic peak flow was comparable in controls and ESRD patients (29.2 +/- 9.1 vs. 27.9 +/- 0.2 mL/100 mL/min), FDR was lower in ESRD patients (116 +/- 31 vs. 88 +/-32%, P < 0.001) because of the shorter duration of vasodilation (127 +/- 36 vs. 96 +/- 32 s, Pt 0.001). The time to complete FDR was longer in ESRD patients (110 +/- 54 vs. 162 +/- 72 s, P < 0.001). ESRD patients had lower high-density lipoprotein cholesterol and serum albumin (P < 0.01) and highertriglycerides fibrinogen, plasma homocysteine, vWF (P < 0.01), and PAI-1 (P < 0.05). For ESRD patients, significant negative age- and pressure-independent correlations were established between FDR and CCA diameter, duration of dialysis, and PAI-1. FDR was positively correlated with serum albumin. FDR and time to FDR were negatively correlated with CCA IMT and LV mass. CCAdistensibility was positively associated with FDR (P < 0.001) and negatively with time to FDR (P < 0.001). The PAI 1 concentration was positively correlated with CCA IMT (P < 0.01) and negatively with CCA distensibility (P <0.001). Conclusions. Our data provide the first evidence that cardiac and arterialremodeling in ESRD patients are inversely related to forearm reactive hyperemia. The diminished hyperemic response is due to the shorter duration of hyperemia and is associated with higher concentrations of serum markers of endothelial activation, suggesting that, in ESRD patients, endothelial dysfunction may be a factor influencing cardiovascular changes.

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Documento generato il 03/04/20 alle ore 07:27:13