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

Alves, C.; Pinho, José Felippe; Santos, Luzia Maria dos; Magalhães, Giselle Santos; Silva, Júnia Maria da; Fontes, Fernanda Luiza; Caligiorne, Sordaini Maria; Pinheiro, Sérgio Veloso Brant; Rodrigues-Machado, Maria Glória

doi:10.1007/s00467-019-04434-0

Cited by 15 publications

(20 citation statements)

References 40 publications

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“…The Mobil-O-Graph s -Pulse Wave Analysis Monitor (IEM, Stolberg, Germany) was used to assess the arterial stiffness indexes, as well as the vascular and hemodynamic parameters (11,12). The PWV was determined using a mathematical model that considered several parameters to analyze pulse wave and wave separation.…”

Section: Assessing Arterial Stiffness and Vascular/ Hemodynamic Parametersmentioning

confidence: 99%

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Predictors and reference equations for augmentation index, an arterial stiffness marker, in healthy children and adolescents

Santos

Gómes

Pinho

et al. 2021

Clinics

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OBJECTIVES: To investigate predictors and propose reference equations for the augmentation index normalized to 75 bpm heart rate (AIx@75) in healthy children and adolescents. METHODS: This was a cross-sectional, observational study involving 134 healthy children and adolescents aged 9 to 19 years old. Participants were categorized into child (n=53) and adolescent (n=81) groups, as well as into male (n=69) and female (n=65) groups. We evaluated AIx@75, vascular and hemodynamic parameters, anthropometric data, physical activity profile, and quality of life (Peds-QL4.0; physical, emotional, social and school domains). RESULTS: The predictors of AIx@75 in the whole sample were age, peripheral diastolic blood pressure (pDBP), mean arterial pressure, pulse pressure amplification (PPA), systolic volume (SV), cardiac index (CI), and pulse wave velocity (PWV; R2=80.47%). In the male group, the predictors of AIx@75 were SV, CI, total vascular resistence (TVR), and PWV (R2=78.56%), while in the female group, they were pDBP, PPA, SV, and PWV (R2=82.45%). In the children, they were pDBP, PPA, SV, and PWV (R2=79.17%), while in the adolescents, they were body mass index, pDBP, PPA, SV, TVR, and PWV (R2=81.57%). CONCLUSION: In the present study, we used a representative sample from Belo Horizonte to establish normality values of AIx@75. We also identified, for the first time, independent predictors of AIx@75 in healthy children and adolescents categorized by sex and age. Determining AIx@75 reference equations may facilitate the early diagnosis of preclinical atherosclerosis and allow an objective measure of the vascular effects of therapeutic interventions aimed at modifying cardiovascular risk factors.

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Section: Assessing Arterial Stiffness and Vascular/ Hemodynamic Parametersmentioning

confidence: 99%

“…AIx is an independent predictor of future cardiovascular events and all-cause mortality (6). It has been evaluated in healthy children and adolescents (7)(8)(9) and is increased in various diseases, such as arterial hypertension (10), chronic kidney disease (11), diabetes (12), asthma (13) and obesity (14)(15)(16).…”

Section: ' Introductionmentioning

confidence: 99%

Predictors and reference equations for augmentation index, an arterial stiffness marker, in healthy children and adolescents

Santos

Gómes

Pinho

et al. 2021

Clinics

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“…A number of epidemiological studies have used adult-validated devices to establish cSBP and cAIx references values in children [29][30][31][32]. Furthermore, ongoing hemodynamic research in the young has led to promising developments for a potential role of central hemodynamic indices as tools for cardiovascular risk stratification or markers of early disease [33][34][35]. As such, the need for paediatric validation of the gTF methodology for estimated central arterial hemodynamics, as well as for other devices such as the Mobil-O-graph (IEM GmbH; Stolberg; Germany) and Arteriograph (TensioMed; Budapest, Hungary) systems, is certainly present and must be addressed.…”

Section: Discussionmentioning

confidence: 99%

Effect of Body Habitus and Heart Rate on Accuracy of Aortic-Radial Transfer Functions for Predicting Central Hemodynamic Indices in Growing Children

Cai¹,

Qasem²,

Butlin³

et al. 2020

Artery Res

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Central Systolic Blood Pressure (cSBP) and Central Augmentation Index (cAIx) have been independently associated with cardiovascular risk in adults, and can be estimated using a generalized peripheral-to-central transfer function. We hypothesize that transfer function accuracy and precision will be influenced by degree of growth and change in body habitus during periods of growth, such as in childhood. We studied the pulse pressure waveforms of 91 healthy children at 8-years of age, and subsequently at 14-years of age. Waveforms were obtained by high-fidelity applanation tonometry of the radial and carotid arteries. Individualized radial-to-carotid transfer functions were formulated at 8-years of age and applied at 14-years of age to estimate cSBP and cAIx. Accuracy was defined as the difference between directly measured and predicted values, and precision as the residuals. Changes in weight (vs. error: b = −0.22, p = 0.04; vs. residuals: b = 0.30; p < 0.01) and body mass index (vs. residuals: b = 0.28, p < 0.01), between 8 and 14 years of age were associated with accuracy and precision of individualized transfer functions in predicting cSBP at 14 years of age. Change in weight (vs. residuals: b = 0.30; p < 0.01) and heart rate (vs. residuals b = 0.32, p < 0.01) were associated with the precision in predicting cAIx. Changes in body habitus and heart rate over a 6-year period of growth are associated with the predictive accuracy and precision of individualized transfer functions in children suggestive of changes in the frequency response characteristics of an individual's vascular system during growth periods.

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“…In another observational study of 38 children and adolescents with NS and 37 healthy controls, augmentation index as the marker for arteriosclerosis was significantly higher in NS patients than in controls [6]. A univariate linear correlation showed that augmentation index positively correlated with TG (r = 0.525; P = 0.001), and total cholesterol (TC) (r = 0.539; P < 0.001), LDL-cholesterol (C) (r = 0.420; P = 0.010), and non-high-density lipoprotein (HDL)-C (r = 0.511; P = 0.001) [6]. A univariate linear correlation showed that augmentation index also positively correlated with the Z-score of central and peripheral blood pressure.…”

Section: Correlation With Other Parametersmentioning

confidence: 90%

“…In general, dyslipidemia accelerates atherosclerosis, and increases risk of myocardial infarction (MI) and cerebrovascular accident. Collected literatures on NS and the makers for atherosclerosis and cardiovascular events were shown in Table 1 [5,6,[9][10][11][12][13][14].…”

Section: Ns and Atherosclerosis And Cardiovascular Diseases (Cvds)mentioning

confidence: 99%

Hyperlipidemia due to Nephrotic Syndrome: Its Effects and Effects of Interventions on Atherogenesis, Cardiovascular and Renal Outcomes

Yanai

2020

J Endocrinol Metab

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Nephrotic syndrome (NS) is one of the most important causes of secondary hyperlipidemia. Here, I describe characteristics and mechanisms for hyperlipidemia due to NS, and systematically reviewed the association of such hyperlipidemia with atherosclerotic progression and the development of cardiovascular diseases (CVD) by Pubmed. Further, I searched literatures on the effects of interventions including diet, statin, fibrates, low-density lipoprotein (LDL)-apheresis and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors on hyperlipidemia and cardiovascular and renal outcomes in NS patients. Although dyslipidemia may be associated with atherosclerosis in NS, other factors such as age, duration of disease, number of relapses and blood pressure are also crucial determinants of atherosclerosis. The disease-specific risk of thromboembolism was different across the histological groups. One cohort study suggested that persons with NS are at increased risk of coronary heart disease (CHD). Among various interventions for NS, statin is relatively safe and effective for hyperlipidemia due to NS, but, it does not show sufficient evidence for cardiovascular and renal outcomes. Although PCSK9 inhibitors are promising therapeutic options for NS, large-scale trials are needed to elucidate such effect.

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

Cited by 15 publications

References 40 publications

Predictors and reference equations for augmentation index, an arterial stiffness marker, in healthy children and adolescents

Predictors and reference equations for augmentation index, an arterial stiffness marker, in healthy children and adolescents

Effect of Body Habitus and Heart Rate on Accuracy of Aortic-Radial Transfer Functions for Predicting Central Hemodynamic Indices in Growing Children

Hyperlipidemia due to Nephrotic Syndrome: Its Effects and Effects of Interventions on Atherogenesis, Cardiovascular and Renal Outcomes

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