B-flow imaging estimation of carotid and femoral atherosclerotic plaques: vessel walls rheological damage or strong predictor of cardiovascular mortality in chronic dialysis patients | springermedicine.com

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International Urology and Nephrology

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01-10-2016 | Nephrology - Original Paper

B-flow imaging estimation of carotid and femoral atherosclerotic plaques: vessel walls rheological damage or strong predictor of cardiovascular mortality in chronic dialysis patients

Authors: Petar Avramovski, Maja Avramovska, Aleksandar Sikole

Published in: International Urology and Nephrology | Issue 10/2016

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Abstract

Background

The aim of this study was to investigate the cardiovascular mortality in chronic hemodialysis patients (CHPs) and to discover the importance of carotid and femoral artery plaques as cardiovascular (CV) mortality predictor.

Methods

In this study with 4 years of follow-up period, we studied a cohort of 101 CHPs. Mean age at entry was 58.1 ± 11.9 years, and mean duration of dialysis was 5.8 ± 5.3 years. We performed B-flow imaging of both carotid and femoral arteries to estimate and score the plaque thickness.

Results

The mean carotid and femoral plaque scores (PSs) at entry were 5.02 ± 4.20 and 4.04 ± 3.30 (p = 0.0002). The carotid cutoff point and femoral cutoff point (by ROC curves) were 5.4 and 5.9. The regression coefficients (b) and Exp (b) hazard ratio coefficients of carotid and femoral PS in Cox regression survival analysis in CV outcomes were: b = 0.142, Exp (b) = 1.153, p = 0.0035 versus b = 0.457, Exp (b) = 1.578, p < 0.0001. Relative hazard ratio (HR) risk of exposed group according to CV events was HR 2.812 (CI 1.301–6.081) for carotid PS and HR 2926 (CI 1.424–6.013) for femoral PS.

Conclusion

Carotid and femoral plaques are strong independent predictors of CV mortality in CHPs. The HR risk of femoral artery plaques is more predictable than HR risk of carotid artery plaques.

1.

Foley RN, Parfrey PS, Sarnak MJ (1998) Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 32:112–119CrossRef

2.

Tyrala K, Amann K (2003) Morphology of the heart and arteries in renal failure. Kidney Int Suppl 84:80–83CrossRef

3.

Lopez Gomez JM, Jofre R, Cases A (2002) Cardiovascular risk factors in chronic renal disease. Nefrologia 22(Suppl 1):59–67PubMed

4.

Avramovski P, Janakievska P, Sotiroski K, Sikole A (2013) Accelerated progression of arterial stiffness in dialysis patients compared with the general population. Korean J Intern Med 28(4):464–474CrossRefPubMedPubMedCentral

5.

Van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS et al (2001) Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke 32(2):454–460CrossRefPubMed

6.

Dalager S, Falk E, Kristensen IB, Paaske WP (2008) Plaque in superficial femoral arteries indicates generalized atherosclerosis and vulnerability to coronary death: an autopsy study. J Vasc Surg 47(2):296–302CrossRefPubMed

7.

Spence JD, Eliasziw M, DiCicco M, Hackam DG, Galil R, Lohmann T (2002) Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy. Stroke 33(12):2916–2922CrossRefPubMed

8.

Kuo F, Gardener H, Dong C, Cabral D, Della-Morte D, Blanton SH et al (2012) Traditional cardiovascular risk factors explain the minority of the variability in carotid plaque. Stroke 43(7):1755–1760CrossRefPubMedPubMedCentral

9.

Spence JD, Barnett PA, Bulman DE, Hegele RA (1999) An approach to ascertain probands with a non-traditional risk factor for carotid atherosclerosis. Atherosclerosis 144(2):429–443CrossRefPubMed

10.

Leng GC, Papacosta O, Whincup P, Wannamethee G, Walker M, Ebrahim S et al (2000) Femoral atherosclerosis in an older British population: prevalence and risk factors. Atherosclerosis 152(1):167–174CrossRefPubMed

11.

Khoury Z, Schwartz R, Gittieb S, Chenzbraun A, Stern S, Keren A (1997) Relation of coronary artery disease to atherosclerotic disease in the aorta, carotid, and femoral arteries evaluated by ultrasound. Am J Cardiol 80(11):1429–1433CrossRefPubMed

12.

Weskott HP (2000) B-flow: a new method for detecting blood flow. Ultraschall Med 21:59–65CrossRefPubMed

13.

Tola M, Yurdakul M, Cumhur T (2004) Combined use of color duplex ultrasonography and B-flow imaging for evaluation of patients with carotid artery stenosis. AJNR Am J Neuroradiol 25(10):1856–1860PubMed

14.

Henri P, Tranquart F (2000) B-flow ultrasonographic imaging of circulating blood. J Radiol 81(4):465–467PubMed

15.

Hétu M, Armstrong DW, Matangi MF, Stroz MJ, Simpson CS, Ewart P (2014) Carotid plaque height helps address the challenge of diagnosing heart disease in women. Can J Cardiol 30(10):S276–S277CrossRef

16.

Salonen JT, Salonen R (1991) Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Arterioscler Thromb 11:1245–1249CrossRefPubMed

17.

Held C, Hjemdahl P, Eriksson SV, Bjorkander I, Forslund L, Rehnqvist N (2001) Prognostic implications of intima-media thickness and plaques in the carotid and femoral arteries in patients with stable angina pectoris. Eur Heart J 22:62–72CrossRefPubMed

18.

Hollander M, Hak AE, Koudstaal PJ, Bots ML, Grobee DE, Hofman A et al (2003) Comparison between measures of atherosclerosis and risk of stroke. The Rotterdam study. Stroke 34:2367–2373CrossRefPubMed

19.

Iino R, Yokoyama N, Konno K, Naito K, Isshiki T (2012) Impact of combined assessment of coronary artery calcium score, carotid artery plaque score, and brachial-ankle pulse wave velocity for early coronary revascularization in patients with suspected coronary artery disease. Int Heart J 53(3):154–159CrossRefPubMed

20.

Antonio B, Emiliana F, Carlo R (2011) Arterial stiffness in chronic kidney disease: the usefulness of a marker of vascular damage. Int J Nephrol 5:73–78

21.

Avramovski P, Janakievska P, Sotirovski K, Zafirovska-Ivanovska B, Sikole A (2014) Aortic pulse wave velocity is a strong predictor of all—cause and cardiovascular mortality in chronic dialysis patients. Ren Fail 36(2):176–186CrossRefPubMed

22.

Ikeda N, Kogame N, Iijima R, Nakamura M, Sugi K (2012) Carotid artery intima-media thickness and plaque score can predict the SYNTAX score. Eur Heart J 33(1):113–119CrossRefPubMed

23.

Kanaan N, Goffin E, Maisin D, Struyven J, Jadoul M (2008) CRP measurement: does the assay matter in hemodialy-sis patients? Clin Nephrol 70:503–507CrossRefPubMed

24.

Owen WF, Lowrie EG (1998) C-reactive protein as an outcome predictor for maintenance hemodialysis patients. Kidney Int 54:627–636CrossRefPubMed

25.

Dalager S, Falk E, Kristensen IB, Paaske WP (2008) Plaque in superficial femoral arteries indicates generalized atherosclerosis and vulnerability to coronary death: an autopsy study. J Vasc Surg 47(2):296–302CrossRefPubMed

26.

Belcaro G, Nicolaides AN, Ramaswami G, Cesarone MR, De SM, Incandela L et al (2001) Carotid and femoral ultrasound morphology screening and cardiovascular events in low risk subjects: a 10-year follow-up study (the CAFES-CAVE study [1]). Atherosclerosis 156(2):379–387CrossRefPubMed

27.

Schmidt C, Fagerberg B, Hulthe J (2005) Non-stenotic echolucent ultrasound-assessed femoral artery plaques are predictive for future cardiovascular events in middle-aged men. Atherosclerosis 181(1):125–130CrossRefPubMed

28.

Garland JS, Simpson CS, Matangi MF, Parfrey B, Hétu M, Johri AM (2014) Plaque quantification by carotid ultrasound may aid in the selection of chronic kidney disease patients requiring coronary angiography. Can J Cardiol 30:276–277CrossRef

29.

Amarenco P, Lavallѐe PC, Labreuche J, Ducrocq G, Juliard JM, Feldman L et al (2011) Prevalence of coronary atherosclerosis in patients with cerebral infarction. Stroke 42:22–29CrossRefPubMed

30.

Siljanovski S, Avramovski P (2009) Carotid artery wall changes as prognostic indicator of coronary artery disease. Maced J Med Sci 2(2):137–140CrossRef

31.

Ogata T, Yasaka M, Yamagishi M, Seguchi O, Nagatsuka K, Minematsu K (2005) Atherosclerosis found on carotid ultrasonography is associated with atherosclerosis on coronary intravascular ultrasonography. J Ultrasound Med 24:469–474PubMed

32.

Blacher J, Pannier B, Guerin AP, Marchais SJ, Safar ME, London GM (1998) Carotid arterial stiffness as a predictor of cardiovascular and all-cause mortality in end-stage renal disease. Hypertension 32(3):570–574CrossRefPubMed

33.

Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM (2001) Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation 103(7):987–992CrossRefPubMed

34.

Blacher J, Guerin AP, Pannier B, Marchais SJ, London GM (2001) Arterial calcification, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension 38(4):938–942CrossRefPubMed

35.

Pascasio L, Blanco F, Giorgini A, Galli G, Corri G, Panzetta G (1996) Echo color doppler imaging of carotid vessels in hemodialysis patients : evidence of high levels of atherosclerotic lesions. Am J Kidney Dis 28(5):713–720CrossRef

Title: B-flow imaging estimation of carotid and femoral atherosclerotic plaques: vessel walls rheological damage or strong predictor of cardiovascular mortality in chronic dialysis patients
Authors: Petar Avramovski
Maja Avramovska
Aleksandar Sikole
Publication date: 01-10-2016
Publisher: Springer Netherlands
Published in: International Urology and Nephrology / Issue 10/2016
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-016-1393-x

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