Document Detail


Renal dysfunction does not affect the peripheral-to-central arterial pressure transfer function.
MedLine Citation:
PMID:  21059999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Arterial generalized transfer functions (GTFs) are increasingly used to estimate central pressure from peripheral measurements. Analysis of derived central waveforms may be valuable in the assessment of patients with chronic kidney disease. The aim of this study was to assess whether the GTF is affected by renal disease. Ninety-four subjects with varying degrees of renal function (Kidney Disease Outcomes Quality Initiative stages 1 to 5; 14 controls) had simultaneous measurements of carotid and radial waveforms made by applanation tonometry. GTFs were calculated by Fourier analysis for each subject group. Derived carotid waveforms were obtained by applying an independently generated GTF to the radial waveform. Glomerular filtration rate inversely correlated with central systolic (R = -0.42; P < 0.001), mean (R = -0.34; P < 0.01) and diastolic (R = --0.27, P < 0.01) blood pressures, as well as central augmentation index (R = -0.30; P< 0.01) and carotid-femoral pulse wave velocity (R = -0.33; P < 0.001). Derived waveforms were not significantly different from measured waveforms in terms of systolic blood pressure, augmentation index, maximum slope, or the delay between the incident and reflected waves, although the derived waveforms slightly underestimated the systolic ejection period (-4.4 ± 0.9 ms; P < 0.001). Overall root-mean-square error was 2.4 ± 0.1 mm Hg. No significant relationship existed between the degree of bias of any derived waveform measure and glomerular filtration rate or chronic kidney disease stage (P > 0.16). No significant differences between chronic kidney disease stages were observed in transfer function gain or phase (P > 0.05). We conclude that the peripheral-to-central GTF is not affected by degree of renal dysfunction and can be used with equivalence in patients with varying degrees of chronic kidney disease.
Authors:
Rupert A Payne; Pajaree Lilitkarntakul; Neeraj Dhaun; Vanessa Melville; Takae Asai; Jane Goddard; David J Webb
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-08
Journal Detail:
Title:  Hypertension     Volume:  56     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-18     Completed Date:  2010-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1083-8     Citation Subset:  IM    
Affiliation:
Clinical Pharmacology Unit, Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh, UK. r.payne@ed.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenergic beta-Antagonists / therapeutic use
Adult
Aged
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Blood Pressure*
Blood Pressure Determination
Brachial Artery / physiopathology
Carotid Arteries / physiopathology*
Chronic Disease
Creatinine / blood
Diuretics / therapeutic use
Glomerular Filtration Rate
Humans
Kidney Diseases / drug therapy,  physiopathology*
Male
Middle Aged
Radial Artery / physiopathology*
Young Adult
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Diuretics; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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