Measuring aortic distensibility with cmr using central pressures estimated in the magnet: comparison with carotid and peripheral pressures

International audienc

Quality of Beverage Intake and Cardiometabolic and Kidney Outcomes: Insights From the STANISLAS Cohort

Background and Aims: Beverages are an important aspect of diet, and their quality can possibly affect health. The Healthy Beverage Index (HBI) has been developed to take into account these effects. This study aimed to highlight the relationships between health and beverage quality by assessing the association of the HBI and its components with kidney and cardiometabolic (CM) outcomes in an initially healthy population-based familial cohort. Methods: This study included 1,271 participants from the STANISLAS cohort. The HBI, which includes 10 components of habitual beverage consumption, was calculated. Associations of the HBI and its components with estimated glomerular filtration rate (eGFR), albuminuria, hypertriglyceridemic waist (HTG waist), metabolic syndrome (MetS), carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT), and left ventricular mass (LV mass) were analyzed using multivariable linear or logistic regression models. Results: The median HBI score was 89.7 (78.6–95) out of 100 points. While the overall HBI score was not significantly associated with any of the studied outcomes, individual HBI components were found differently associated with the outcomes. cfPWV and cIMT were lower in participants who did not meet the full-fat milk criteria (p = 0.03 and 0.001, respectively). In men, higher cfPWV was observed for the “low Fat milk” (p = 0.06) and “alcohol” (p = 0.03) non-adherence criteria. Odds of HTG waist were higher with the non-adherence to sugar-sweetened beverages criteria (p < 0.001). eGFR was marginally higher with non-adherence to the coffee/tea criteria (p = 0.047). Conclusions: In this initially healthy population, HBI components were differently associated with kidney and cardiometabolic outcomes, despite a good overall HBI score. Our results highlight specific impacts of different beverage types and suggest that beverages could have an impact on kidney and cardiometabolic health

Carotid-Femoral Pulse Wave Velocity: An Urgent Need for a Harmonization of Denominations

International audienc

Etude pharmacogénétique chez l' homme et la souris mutante (rôle du système rénine-angiotensine dans la rigidité artérielle)

PARIS7-Bibliothèque centrale (751132105) / SudocSudocFranceF

How to calculate ventricular–arterial coupling?

International audienc

Comparison of the Complior Analyse device with Sphygmocor and Complior SP for pulse wave velocity and central pressure assessment

BACKGROUND: The Complior device (Alam Medical, France) was used in epidemiological studies which established pulse wave velocity (PWV) as a cardiovascular risk marker. Central pressure is related, but complementary to PWV and also associated to cardiovascular outcomes. The new Complior Analyse measures both PWV and central blood pressure during the same acquisition. The aim of this study was to compare PWV values from Complior Analyse with the previous Complior SP (PWVcs) and with Sphygmocor (PWVscr; AtCor, Australia), and to compare central systolic pressure from Complior Analyse and Sphygmocor. METHOD: Peripheral and central pressures and PWV were measured with the three devices in 112 patients. PWV measurements from Complior Analyse were analysed using two foot-detection algorithms (PWVca_it and PWVca_cs). Both radial (ao-SBPscr) and carotid (car-SBPscr) approaches from Sphygmocor were compared to carotid Complior Analyse measurements (car-SBPca). The same distance and same calibrating pressures were used for all devices. RESULTS: PWVca_it was strongly correlated to PWVscr (R(2) = 0.93, P < 0.001) with a difference of 0.0 ± 0.7  m/s. PWVca_cs was also correlated to PWVcs (R(2) = 0.90, P < 0.001) with a difference of 0.1 ± 0.7  m/s. Central systolic pressures were strongly correlated. The difference between car-SBPca and ao-SBPscr was 3.1 ± 4.2  mmHg (P < 0.001), statistically equivalent to the difference between car-SBPscr and ao-SBPscr (3.9 ± 5.8  mmHg, P < 0.001), whilst the difference between car-SBPca and car-SBPscr was negligible (-0.7 ± 5.6  mmHg, P = NS). CONCLUSION: The new Complior Analyse device provides equivalent results for PWV and central pressure values to the Sphygmocor and Complior SP. It reaches Association for the Advancement of Medical Instrumentation standard for central blood pressure and grades as excellent for PWV on the Artery Society criteria. It can be interchanged with existing devices

Reproducibility in Echotracking Assessment of Local Carotid Stiffness, Diameter and Thickness in a Population-based Study (The STANISLAS Cohort Study)

International audienceBackground: Carotid Intima Media Thickness (IMT) and stiffness are associated with cardiovascular events. The study aims were to perform a head-to-head comparison of the Wall Track System (WTS) and ART.LAB for carotid IMT, distension and diameter echotracking measurements as well as inter-and intra-observer reproducibility. Methods: Echotracking measurements were performed with WTS and ART.LAB in 188 participants from the STANISLAS Cohort (mean age 47 ± 14 years). Inter-observer reproducibility analysis was performed in 60 patients consecutively included among the STANISLAS Cohort and two other ongoing cohorts, in whom measurements were successively performed by three operators. Results: The relative differences between WTS and ART.LAB in artery diameter measurements were minimal (mean difference −1.8%) while the differences in IMT and distension measurements were 6.1% and 4.3%, respectively. The Bland and Altman plots for diameter, distension and intima media thickness showed no measurement bias between ART.LAB and WTS. The internal reproducibility for carotid diameter was good with the two devices (≈2% SD). The ART.LAB performed ≈2-fold better than WTS for IMT internal reproducibility (5% vs. 12.5%, p < 0.0001) and distension internal reproducibility (6.3% vs. 12.4%, p < 0.0001). The inter-and intra-observer reproducibility for carotid diameter and IMT was good for both devices. Complete results were obtained in 1:50 min in ART.LAB and 11:13 min with WTS. Conclusion: ART.LAB and WTS show good agreement, with good inter-and intra-observer reproducibility with the two devices. Nevertheless, internal reproducibility of ART.LAB is better and measurements are easier to perform, favouring this device for carotid intima media thickness and stiffness measurements

Cardiovascular Comorbidities Are the Main Predictors of Cardiac Reverse Remodeling following Kidney Transplantation

International audienceBackground: End-stage renal disease is associated with cardiac remodeling, which is partly reversible after kidney transplantation (KT). We aimed to determine the association of cardiovascular comorbidities or kidney-related factors with cardiac reverse remodeling after KT.Methods: We performed echocardiography in 56 patients (aged 48 ± 15 years, mean ± SD) before and 24 months after undergoing their first KT. Echocardiograms were reviewed using a standardized process with blinding for the patient characteristics and evaluation timing. Multivariable linear regression analysis was used to evaluate the association between comorbidities and changes in cardiac structure and systolic/diastolic function.Results: Left ventricular mass index (LVMI) and diastolic parameters did not change significantly, while left ventricular ejection fraction (LVEF) increased from 63.9 to 69.6% (p = 0.046). Multivariable analysis revealed associations of histories of valvular heart disease with a smaller reduction in LVMI (β = -27.3, p = 0.04), of coronary artery disease or heart failure with a smaller increase in LVEF (β = 7.17, p = 0.02), and of diabetes mellitus with less improvement in E wave (β = -0.19, p = 0.05), e' (β = 4.15, p = 0.046), and E/e' (β = -5.00, p < 0.01).Conclusion: Cardiovascular comorbidities were -associated with less improvement in cardiac structure and function following KT. Our findings suggest that patients with CV comorbidities may experience limited "favorable" reverse cardiac remodeling following KT

Reversal of Arterial Stiffness and Maladaptative Arterial Remodeling After Kidney Transplantation

International audienceBackground Chronic kidney disease is characterized by stiffening, thinning, dilatation, and increased circumferential wall stress of large arteries, associated with increased cardiovascular risk. Kidney transplantation (KT) reverses many pathological features of chronic kidney disease and improves life expectancy; however, longitudinal studies exploring the impact of KT on recipient large arteries are scarce.Methods and Results This study was designed to appraise arterial changes following KT. Carotid‐femoral pulse wave velocity, carotid remodeling (circumferential wall stress and carotid internal diameter), and stiffness were measured in 161 consecutive recipients receiving either a living (n=49) or a deceased (n=112) donor allograft, at 3 and 12 months after transplantation. Mean pulse wave velocity decreased from 10.8 m/s (95% confidence interval, 10.5–11.2 m/s) (at month 3) to 10.1 m/s (95% confidence interval, 9.8–10.5 m/s) (at month 12) (P<0.001). After multivariate adjustment, pulse wave velocity reduction from month 3 to month 12 was significantly larger in the living donor allograft KT (P<0.001). Circumferential wall stress decreased, 70 kPa (95% confidence interval, 68–72 kPa) to 64 kPa (95% confidence interval, 62–67 kPa), as well as carotid internal diameter and carotid stiffness (P<0.001 for all). Reductions in circumferential wall stress, diameter, and stiffness were significantly larger in the living donor allograft KT (P<0.001). When deceased donor allograft patients were classified into standard and expanded criteria donors, changes in both pulse wave velocity and circumferential wall stress were blunted in expanded criteria donors. Changes were independent of graft function and blood pressure changes.Conclusions Large‐artery stiffness and maladaptive carotid artery remodeling of chronic kidney disease is partially reversed within 12 months of KT and appears unrelated to renal function. Improvements were independently associated with live organ donation. Our data suggest that expanded criteria donors may hamper vascular recovery