A New Echocardiographic Parameter of Arterial Stiffness in End-Stage Renal Disease

Abstract

Background. Cardiovascular disease is the leading cause of death among patients with end-stage renal disease (ESRD). Arterial stiffness is an independent predictive parameter of overall and cardiovascular mortality in these patients. However, the defined procedures for the measurement of arterial stiffness are time consuming and not practical in daily practice. Methods. The study population included 50 patients with ESRD who were treated with hemodialysis (HD; n=23) or peritoneal dialysis (PD; n=27) and 70 age-and sex-matched control subjects. Aortofemoral pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and color M-mode propagation velocity of the descending aorta (aortic propagation velocity, APV) were measured. Results. Compared to the control group, the patients with ESRD had significantly lower APV (46.4 +/- 12.4 vs. 58.5 +/- 8.5, p<0.01) and higher PWV (10.5 +/- 2.5 vs. 9.2 +/- 1.2, p<0.01) and CIMT (0.66 +/- 0.15 vs. 0.43 +/- 0.06, p<0.01) measurements. There were significant correlations between APV and CIMT (r=-0.769, p<0.001), APV and PWV (r=-0.682, p<0.001), and PWV and CIMT (r=0.564, p<0.001). There were no significant differences in APV and PWV between the PD and HD patients. Conclusion. Arterial stiffness is an important indicator of atherosclerosis and arterial aging in patients with ESRD. The measurement of APV is an easy and practical new echocardiographic method and may be used to identify arterial stiffness in these patients.