Coronary flow reserve dysfunction in hemodialysis and kidney transplant patients

Çalışkan, Yaşar; Oflaz, Hüseyin; Demirtürk, Mustafa; Yazıcı, Halil; Türkmen, Aydın; Çımen, Arif Oğuzhan; Elıtok, Ali; Yildiz, Alaattin

doi:10.1111/j.1399-0012.2008.00879.x

Cited by 32 publications

(30 citation statements)

References 28 publications

(38 reference statements)

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“…By using this method, early coronary microvasculature pathology and ED can be investigated [6,7]. Decreased CFR values (CFR <2) reflect coronary ED and may be evidence of severe coronary artery disease [6,7,8,9]. In our previous study, we have also demonstrated that impaired CFR was significant in PD patients [10].…”

Section: Introductionmentioning

confidence: 93%

“…The CFR measurement which reflects coronary microvascular function and endothelial functions of epicardial coronary arteries by TTDE, as a cheaper and easy screening test, may be used as a detection method in the assessment of major epicardial coronary arteries [7,8,9,10]. Impairment of the CFR (CFR <2) has been suggested to be a preclinical sign of CV events and is characterized by a decreased capacity of the coronary dilatation following an increase in myocardial metabolic demands [7,8,9,10].…”

Section: Discussionmentioning

confidence: 99%

“…The intra-observer variability of CFR measurement was 3.6% in the current study. CFR <2.0 was considered abnormal [8,9,10]. …”

Section: Methodsmentioning

confidence: 99%

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Cardiac Biomarkers and Noninvasive Predictors of Atherosclerosis in Chronic Peritoneal Dialysis Patients

Çalışkan

Özkök²,

Akagun³

et al. 2012

Kidney Blood Press Res

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Background: We investigated the relationship among serum cardiac biomarkers including N-terminal pro-brain natriuretic peptide (NT-pro-BNP), cardiac troponin T (cTnT), uric acid and high-sensitive C-reactive protein (hs-CRP) and noninvasive predictors of atherosclerosis including carotid intima-media thickness (IMT), aortic stiffness (pulse wave velocity (PWV)) and transthoracic coronary flow reserve (CFR) in peritoneal dialysis (PD) patients. Methods: 37 PD patients were included in the study. We measured (1) carotid IMT, (2) PWV and augmentation index (AIx), and (3) CFR. Simultaneous measurements of serum NT-pro-BNP, cTnT, uric acid and hs-CRP were also performed. Associations among these variables were analyzed. Results: cTnT was significantly associated with carotid IMT (r = 0.747, p < 0.001), PWV (r = 0.431, p = 0.035) and CFR (r = –0.439, p = 0.007). In multivariate analysis, cTnT was a significant independent predictor of carotid IMT (β = 4.446, p < 0.001) and CFR (β = –2.272, p = 0.013). Patients with high cTnT levels (≥0.01 ng/ml) significantly hadhigher carotid IMT and PWV values. Only the aortic PWV significantly correlated with residual renal function (r = –0.574, p = 0.004). Conclusions: Serum cTnT appeared to be a useful clinical biomarker for evaluating noninvasive predictors of atherosclerosis in chronic PD patients. Arterial stiffness as determined by PWV is also correlated with residual renal function.

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Section: Introductionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Cardiac Biomarkers and Noninvasive Predictors of Atherosclerosis in Chronic Peritoneal Dialysis Patients

Çalışkan

Özkök²,

Akagun³

et al. 2012

Kidney Blood Press Res

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“…[13] In a recent study, decreased CFR values were detected in 89.6% and 59.3% of HD and renal transplant patients, respectively. [22] However, in this study, decreased CFR values were noted in 14 of 24 (58.3%) patients. This is the first study to provide data of CFR values in PD patients.…”

Section: Discussionmentioning

confidence: 46%

“…This may be the reason for the low rate of PD patients with decreased CFR values compared to HD or renal transplant patients in the previous studies. [22] Many well-defined CV risk factors that may affect coronary microvascular and endothelial functions in PD patients, including age, gender, smoking status, BMI, blood pressure, and cholesterol levels, were similar in the low CFR and high CFR groups. We therefore studied ghrelin and leptin levels as new CV risk factors.…”

Section: Discussionmentioning

confidence: 99%

Plasma Ghrelin Levels Are Associated with Coronary Microvascular and Endothelial Dysfunction in Peritoneal Dialysis Patients

et al. 2009

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Cardiovascular (CV) disease is the main cause of death in peritoneal dialysis (PD) patients, and endothelial dysfunction (ED)is an early sign of vascular pathology. Ghrelin, a gastric peptide with CV actions, has been shown to inhibit proatherogenic changes in experimental models. However, another peptide hormone, leptin, may mediate deleterious effects on the CV system. The aim of this study is to evaluate the relationship between plasma ghrelin and leptin levels, and their association with coronary microvascular and endothelial functions in PD patients. Twenty-four (14 females and 10 males; mean age 44 ± 12 yr) nondiabetic PD patients, between 18 and 70 years of age, were enrolled. In addition to demographic, clinical, and laboratory parameters, plasma concentrations of ghrelin and leptin were evaluated. Endothelial functions of the coronary arteries were determined by coronary flow reserve (CFR) measurement using transthoracic Doppler echocardiography (TTDE). A CFR value of < 2 was used as an evidence for ED. When the study group was divided according to CFR measurements as CFR < 2 and ≥ 2, there were no significant differences considering age, gender, etiology of renal disease, body mass index (BMI), duration of dialysis, PD modality, PD solution type, history of peritonitis, mean arterial pressure, ejection fraction, and biochemical parameters between the two subgroups. Plasma ghrelin levels (129.4 ± 82.1 pg/mL) in patients with CFR ≥ 2 were significantly higher than those in patients with CFR< 2 (63.3 ± 35.8 pg/mL) (p = 0.03). However, no significant differences in plasma leptin levels were found between these groups [31.39 ± 37.81 ng/mL vs. 63.95 ± 72.83 ng/mL (p = 0.28)]. No correlation existed between plasma ghrelin levels and age, BMI, duration of dialysis, mean arterial pressure, ejection fraction, plasma leptin levels, and biochemical parameters. Decreased plasma ghrelin levels may contribute to the development of atherosclerosis in PD patients by causing ED.

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Cardiac testing for coronary artery disease in potential kidney transplant recipients

Wang

Fahim

Hayen

et al. 2011

Cochrane Database of Systematic Reviews

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Coronary flow reserve dysfunction in hemodialysis and kidney transplant patients

Cited by 32 publications

References 28 publications

Cardiac Biomarkers and Noninvasive Predictors of Atherosclerosis in Chronic Peritoneal Dialysis Patients

Cardiac Biomarkers and Noninvasive Predictors of Atherosclerosis in Chronic Peritoneal Dialysis Patients

Plasma Ghrelin Levels Are Associated with Coronary Microvascular and Endothelial Dysfunction in Peritoneal Dialysis Patients

Cardiac testing for coronary artery disease in potential kidney transplant recipients

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