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Análisis comparativo de la rigidez arterial evaluada en forma no invasiva en pacientes hemodializados

Authors: Galli, Cinthia; Valtuille, Rodolfo; Percunte, Maia Daniela; Carrizo, Nahuel Hernán; Bia, Daniel; Armentano, Ricardo; Cabrera Fischer, Edmundo;

Análisis comparativo de la rigidez arterial evaluada en forma no invasiva en pacientes hemodializados

Abstract

pacientes hemodializados se producen en vasos elásticos y musculares pero sólo la Velocidad de la Onda del Pulso (VOP) aórtica ha demostrado ser un índice de alto valor pronóstico. Lo cual deja de lado a las arterias musculares. Los objetivos del estudio fueron: a) medir la VOP aórtica y la carotido-radial de pacientes hemodializados, y b) repetir el análisis anterior en la misma cohorte 5 años después, comparando cuatro índices diferentes de rigidez arterial. Material y métodos: a 23 pacientes hemodializados se les evaluó la VOP aórtica (VOPcf), la carotido-radial (VOPcr) y se calculó: la VOP centro-periférica (VOPcp), la diferencia (ΔVOP), el desacople de VOP y su cambio porcentual (%VOP). Las evaluaciones se hicieron en 2007 (Tiempo 1) y en 2012 (Tiempo 2). Resultados: La VOPcp mostró un aumento significativo entre la evaluación realizada entre el Tiempo 1 y el 2 (de 1.1±0.3 a 1.4±0.4; p<0.01). En los mismos tiempos ΔVOP mostró que los valores se incrementaban en términos negativos (de -0.9±3.0 a -2.7±2.9; p<0.05). El desacople de la rigidez centro-periférica mostró un significativo aumento (valores negativos) entre el Tiempo 1 y 2 (de 0.0±0.1 a -0.1±0.1; p<0.02). El %VOP ANÁLISIS COMPARATIVO DE LA RIGIDEZ ARTERIAL EVALUADA EN FORMA NO INVASIVA EN PACIENTES HEMODIALIZADOS COMPARATIVE ANALYSIS OF ARTERIAL STIFFNESS NON INVASIVELY EVALUATED IN HEMODIALYZED PATIENTS Cinthia Galli (1,2), Rodolfo Valtuille (3), Maia Daniela Percunte (2), Nahuel Hernán Carrizo (2), Daniel Bia (4), Ricardo Armentano (1,2), Edmundo Cabrera Fischer (1,2) 1) Área de Investigación y Desarrollo Universidad de Favaloro (AIDUF), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires 2) Facultad Regional Buenos Aires, Universidad Tecnológica Nacional, Buenos Aires 3) Fresenius FME Burzaco, Buenos Aires 4) Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay Nefrología, Diálisis y Trasplante 2016; 36 (1) Pág. 26-33 entre ambas mediciones (valores negativos) mostró un significativo aumento (de -4.8±22.0 a -21.5±24.2; p<0.05). Conclusiones: en la presente investigación los índices de rigidez obtenidos en pacientes hemodializados, incluyendo arterias tanto elásticas y musculares, mostraron diferencias estadísticamente significativas cuando se compararon dos mediciones separadas por cinco años. Sin embargo los niveles de significación no fueron similares.

Objectives: Changes in arterial stiffness in hemodialysis patients occur both, in elastic and muscular vessels but only the aortic Pulse Wave Velocity (PWV) has demonstrated to be a high prognostic value index, however, muscular arteries are not involved in the aortic PWV measurement. The purpose of this research was: a) to evaluate the aortic and carotid-radial PWV of hemodialysis patients, b) to repeat these measurements in the same cohort after 5 years comparing four different arterial stiffness indexes. Methods: 23 hemodialyzed patients carotid-femoral PWV (PWVcf) and carotidradial (PWVcr) were evaluated and calculations were as follows: PWV ratio, PWV difference (/ PWV), PWV mismatch and PWV percentage change (%PWV). These evaluations were performed using data obtained in 2007 (Time 1) and 2012 (Time 2). Results: PWV ratio showed a significant increase between measurements performed in Time 1 and 2 (from 1.1±0.3 to 1.4±0.4; p≤0.01). Similar increases in negative terms were found when /PWV was calculated from -0.9±3.0 to -2.7±2.9; p≤0.05) Calculated values of PWV mismatch increased significantly (negative values) between Time 1 and 2 (from 0.0±0.1 to -0.1±0.1; p≤0.02) Percent changes of PWV between Time 1 and 2 (negative values) showed a significant increase (from -4.8±22.0 to -21.5±24.2; p≤0.05). Conclusions: Stiffness indexes, obtained in hemodialyzed patients including both elastic and muscular arteries used in this research showed statistically significant differences when two measures with 5 years interval were compared. However significance levels were not similar.

Fil: Cabrera Fischer, Edmundo Ignacio. Universidad Favaloro. Área de Investigación y Desarrollo; Argentina. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Fil: Armentano, Ricardo Luis. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Universidad Favaloro. Área de Investigación y Desarrollo; Argentina

Fil: Galli, Cintia Nora. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Universidad Favaloro. Área de Investigación y Desarrollo; Argentina

Fil: Percunte, Maia Daniela. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina

Fil: Carrizo, Nahuel Hernán. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina

Fil: Valtuille, Rodolfo. Fresenius Medical Care Burzaco; Argentina

Fil: Bia, Daniel. Universidad de la República; Uruguay

Country
Argentina
Keywords

aortic stiffness, hemodialysis, RIGIDEZ ARTERIAL, pulse wave velocity, hemodiálisis; rigidez arterial, velocidad de la onda del pulso, rigidez aórtica, ELASTICIDAD ARTERIAL, arterial stiffness, VELOCIDAD DE LA ONDA DEL PULSO, https://purl.org/becyt/ford/3.2, HEMODIALISIS, https://purl.org/becyt/ford/3

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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