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Alteration of proximal aorta biophysical properties in patients with end stage renal disease

机译：终末期肾脏疾病患者近端主动脉生物物理特性的改变

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摘要

Objective: To present a novel, non-invasive echocardiographic application to assess the structural and functional properties of the complex composition of the proximal aorta in patients with end stage renal disease (ESRD). Methods: 71 haemodialysis patients (mean (SD) age 61.3 (9.3) years, dialysis duration 79.2 (51.6) months) and 62 age matched controls were studied. From the suprasternal view, the distance between ascending and descending aorta was measured with two dimensional ultrasound. The aortic flow wave transit time was measured with pulsed wave Doppler. M mode echocardiography, with simultaneous blood pressure estimates, was used to assess the diameters of the aortic annulus and of the ascending aorta. Pulse pressure, pulse wave velocity (PWV), pressure strain elastic modulus, characteristic impedance, and β index were calculated. Results: Patients had increased pulse pressure (68.0 (7.2) v 51.4 (5.0) mm Hg, p < 0.001), PWV (6.1 (1.1) v 3.9 (0.6) m/s, p < 0.001), characteristic impedance (174(58) v 111 (31) m/s·cm~2, p < 0.001), pressure strain elastic modulus (872 (254) v 541 (140) mm Hg, p < 0.001), and β index (8.9 (3.4) v 5.5 (1.4), p < 0.001) compared with controls. In patients PWV was correlated with age and time on haemodialysis (r = 0.44, p < 0.001, and r = 0.51, p < 0.001, respectively). Conclusion: A novel application of duplex ultrasound of the proximal aorta showed that patients with ESRD have impaired proximal aortic function compared with controls. The data indicate that these non-invasive measurements can be used to describe status and change in aortic biophysical properties and may be used as a marker for cardiovascular disease risk.
机译：目的：介绍一种新型的，非侵入性的超声心动图应用程序，以评估终末期肾脏病（ESRD）患者近端主动脉复杂成分的结构和功能特性。方法：研究了71名血液透析患者（平均（SD）年龄61.3（9.3）岁，透析持续时间79.2（51.6）个月）和62名年龄匹配的对照组。从胸骨上方的角度，用二维超声测量升主动脉和降主动脉之间的距离。用脉冲多普勒测量主动脉流波的传播时间。 M型超声心动图，同时进行血压估计，用于评估主动脉瓣环和升主动脉的直径。计算脉压，脉搏波速度（PWV），压力应变弹性模量，特性阻抗和β指数。结果：患者的脉压升高（68.0（7.2）v 51.4（5.0）mm Hg，p <0.001），PWV（6.1（1.1）v 3.9（0.6）m / s，p <0.001），特征阻抗（174（ 58）v 111（31）m / s·cm〜2，p <0.001），压力应变弹性模量（872（254）v 541（140）mm Hg，p <0.001）和β指数（8.9（3.4）与对照相比，v 5.5（1.4），p <0.001）。在患者中，PWV与血液透析的年龄和时间相关（r = 0.44，p <0.001，r = 0.51，p <0.001）。结论：双主动脉近端超声的新应用表明，与对照组相比，ESRD患者近端主动脉功能受损。数据表明，这些非侵入性测量可用于描述主动脉生物物理特性的状态和变化，并可作为心血管疾病风险的标记。

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