Abstract
Measurement of aortic pulse wave velocity (PWV) is one of the useful and reliable tools for estimating atherosclerosis. PWV has been applied to hemodialyzed (HD) chronic renal failure (CRF) patients in whom atherogenic disorder frequently induced critical complications. In this study, we initially measured PWV in 112 HD patients compared with conventional parameters related to atherosclerosis, such as blood pressure (BP), serum chemical data and aortic calcification index (ACI). Secondly, to investigate the effect of each HD maneuver on PWV, especially, how the PWV changes in response to decreases in BP after dialysis, related factors and autonomic function were analyzed. Using the oscillometric method, hbPWV (heart-brachial) and baPWV (brachial-ankle) were measured. Twenty patients were compared by PWV response after dialysis, and autonomic function were evaluated by analysis of the heart rate interval (RR interval SDNN). Ten patients were also evaluated by spectral analysis, on which the high frequency (HF) component is thought to correlate with parasympathetic nervous system activity, and the low frequency (LF) component with sympathetic nervous system activity. These tests were performed to assess change in autonomic nervous system activity during the dialysis session. The PWV significantly correlated with age and blood pressure on logistic regression analysis, while baPWV significantly correlated with ACI. In the patients with an absence of any decrease in PWV in response to BP decrease, baPWV correlated with age, BP and ACI with a reduced RR interval suggesting autonomic dysfunction. PWV is a useful functional test for atherosclerosis and changes in PWV before and after dialysis may be implicated in the pathophysiology of atherosclerosis and autonomic nervous system disorders.
