title: Altered proximal aortic stiffness and endothelin plasma levels in diabetic patients with end-stage renal disease.
abstract: Peripheral artery stiffness is altered in diabetic patients with end-stage renal disease (ESRD), whereas few data exist to confirm this trend for proximal aortic stiffness. The pulse wave velocity of the proximal aorta (PWVr) and of the carotid-to-femoral aortic segment (PWVcf) were determined by ultrasound imaging in 160 patients with ESRD (70 diabetic) and in 160 matched control subjects. Also, plasma levels of endothelin, homocysteine, and high-sensitivity C-reactive protein were determined in both groups. Patients with ESRD had increased pulse pressure, left ventricular (LV) end-diastolic diameter, LV mass index, PWVr, and PWVcf compared with control subjects (p < 0.05). Diabetic patients had increased LV mass index, PWVr, and PWVcf compared with nondiabetic patients with ESRD (p < 0.05). Endothelin levels exhibited a strong relation with PWVr (r = 0.32, p < 0.001) and PWVcf (r = 0.33, p < 0.001) measurements in ESRD patients. Multivariate linear regression analysis revealed that age, diabetes, and plasma levels of endothelin were major determinants of increased PWVr measurements in the total ESRD population. After adjustment for age, body surface area, time on dialysis, systolic blood pressure, history of hypertension, and plasma endothelin levels, diabetes was an independent factor associated with PWVr in ESRD subjects. Diabetic patients with ESRD had significantly increased proximal aortic stiffness and significantly altered plasma levels of endothelin as compared with the nondiabetic.
authors.affiliation: Department of Nephrology, University Hospital of Heraklion, Crete, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karakitsos
authors.forename: Alexandros P
authors.initials: AP
authors.lastname: Patrianakos
authors.forename: Frangiskos I
authors.initials: FI
authors.lastname: Parthenakis
authors.forename: Niki
authors.initials: N
authors.lastname: Malliaraki
authors.forename: Draguena
authors.initials: D
authors.lastname: Nikitovic
authors.forename: John
authors.initials: J
authors.lastname: Kyriazis
authors.forename: Andreas
authors.initials: A
authors.lastname: Karabinis
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Groothoff
authors.forename: Eric
authors.initials: E
authors.lastname: de Groot
authors.forename: Costas
authors.initials: C
authors.lastname: Fourtounas
authors.forename: Eugene
authors.initials: E
authors.lastname: Daphnis
authors.forename: Panos E
authors.initials: PE
authors.lastname: Vardas
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000378:metabolism*; D004452:Echocardiography; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011673:Pulsatile Flow; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D019332:Endothelin-1; D014280:Triglycerides; D006710:Homocysteine; D002097:C-Reactive Protein