title: Alteration of proximal aorta biophysical properties in patients with end stage renal disease.
abstract: 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 beta 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.cm2, p < 0.001), pressure strain elastic modulus (872 (254) v 541 (140) mm Hg, p < 0.001), and beta 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Heraklion University Hospital, Crete, Greece.
authors.forename: A P
authors.initials: AP
authors.lastname: Patrianakos
authors.forename: D
authors.initials: D
authors.lastname: Karakitsos
authors.forename: D N
authors.initials: DN
authors.lastname: Karakitsos
authors.forename: E
authors.initials: E
authors.lastname: de Groot
authors.forename: F I
authors.initials: FI
authors.lastname: Parthenakis
authors.forename: E K
authors.initials: EK
authors.lastname: Daphnis
authors.forename: P E
authors.initials: PE
authors.lastname: Vardas
mesh_terms: D001011:Aorta / Q000000981:diagnostic imaging / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D006435:Renal Dialysis; D015203:Reproducibility of Results; D014655:Vascular Resistance / Q000502:physiology