Relationship between brachial-ankle and heart-femoral pulse wave velocities and the rapid decline of kidney function

Abstract

The impact of brachial-ankle pulse wave velocity (baPWV) and heart-femoral pulse wave velocity (hfPWV) on rapid decline of estimated glomerular filtration rate (eGFR) has been inconclusive. The database of a multicenter prospective study of 2238 patients in Korea enrolled from 2011 to 2016 was reviewed. After excluding patients with missing baPWV (n = 257) and eGFR change (n = 180), the study included 1801 non-dialysis chronic kidney disease (CKD) patients. The eGFR change <−5ml/min/1.73 m2/year was defined as rapid decline. During a mean of 2.2 years, the mean eGFR change was −3.6 ml/min/1.73 m2/year, and 31.6% of patients were classified as having rapid decline. Older age, causes of CKD, increased heart rate, systolic blood pressures, and proteinuria were associated with the highest baPWV quintile. In multivariate logistic regression analyses, the odds of a rapid decline in eGFR was 1.9 times higher in the fifth quintile than in the first quintile (P = 0.013). In a subset with baPWV and hfPWV (n = 1182), high baPWV was associated with rapid eGFR decline only when accompanied by a high hfPWV. These findings suggest that central and peripheral PWVs may simultaneously affect rapid eGFR decline.

Associations between carotid-femoral and heart-femoral pulse wave velocity in older adults: the Atherosclerosis Risk In Communities study

“…Besides the study by Choo et al, [6] seven other studies have reported on hfPWV and cardiovascular-related outcomes, [7][8][9][10][11][12][13] of which three also included cfPWV. [10][11][12] Collectively, these studies report that hfPWV is positively associated with age, [7] N-terminal pro b-type natriuretic peptide (NT-proBNP),[12] blood pressure, [7] diabetes, [7] albumin-creatinine ratio (ACR) [10] and aldosterone, [9] and negatively associated with either estimated glomerular filtration rate (eGFR).…”

“…[10][11][12] Collectively, these studies report that hfPWV is positively associated with age, [7] N-terminal pro b-type natriuretic peptide (NT-proBNP),[12] blood pressure, [7] diabetes, [7] albumin-creatinine ratio (ACR) [10] and aldosterone, [9] and negatively associated with either estimated glomerular filtration rate (eGFR). [8,10,12] The comparative studies report that both cfPWV and hfPWV are positively associated with proBNP[12] and ACR, [10] and negatively associated with eGFR, [10] but that the highest quartile of cfPWV was most strongly associated with CVD, especially heart failure. [11] It should be acknowledged that the later study [11] and the current study utilized ARIC participants, and we do report greater variability between hfPWV and cfPWV at higher PWV values.…”

“…To date, of the few studies on hfPWV [7][8][9][10][11][12][13][14] only one directly compared hfPWV to cfPWV. [6] While the previous study reported a strong correlation (r = 0.81) between the two measures, systemic bias was not explored, the study did not include women, and the age range of the population was narrow (40-49 years).…”

The Correlation of Serum Osteoprotegerin with Non-Traditional Cardiovascular Risk Factors and Arterial Stiffness in Patients with Pre-Dialysis Chronic Kidney Disease: Results from the KNOW-CKD Study

“…A VP-1000 analyzer (Collin Co., Komaki, Japan) was used for measuring baPWV. As reported previously,15 this device takes a measurement of ankle-to-brachial index by using the electrocardiogram, phonocardiogram, and pressure waveforms. Pressure waveforms of the brachial and tibial arteries were documented with plethysmographic and oscillometric pressure sensors using occlusion/sensing cuffs that were twined around both arms and both ankles.…”

Acute Changes in Carotid-Femoral Pulse-Wave Velocity Are Tracked by Heart-Femoral Pulse-Wave Velocity

“…The hfPWV approach confers a number of potential advantages over cfPWV: (i) it is simpler to conduct, as the measurement is not dependent on assessment of the carotid artery; (ii) the measurement path is consistent with the blood flow path; and, (iii) it incorporates the proximal aorta. Although measures of hfPWV have previously been used as a clinical or epidemiological cardiovascular monitoring tool (17)(18)(19)(20)(21)(22), only two studies have determined its association with the criterion, cfPWV (13,23). Both studies reported strong correlations (r = 0.81-0.83) between hfPWV and cfPWV in community dwelling healthy middle-aged (13) and older adults (23).…”