Reversal of Arterial Stiffness and Maladaptative Arterial Remodeling After Kidney Transplantation
Identifieur interne : 000434 ( Main/Exploration ); précédent : 000433; suivant : 000435Reversal of Arterial Stiffness and Maladaptative Arterial Remodeling After Kidney Transplantation
Auteurs : Alexandre Karras ; Pierre Boutouyrie ; Marie Briet ; Erwan Bozec ; Jean-Philippe Haymann ; Christophe Legendre ; Lawrence P. Mcmahon ; Michel DelahousseSource :
- Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease [ 2047-9980 ] ; 2017.
Abstract
Chronic kidney disease is characterized by stiffening, thinning, dilatation, and increased circumferential wall stress of large arteries, associated with increased cardiovascular risk. Kidney transplantation (
This study was designed to appraise arterial changes following
Large‐artery stiffness and maladaptive carotid artery remodeling of chronic kidney disease is partially reversed within 12 months of
Url:
DOI: 10.1161/JAHA.117.006078
PubMed: 28889098
PubMed Central: 5634273
Affiliations:
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Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Reversal of Arterial Stiffness and Maladaptative Arterial Remodeling After Kidney Transplantation</title>
<author><name sortKey="Karras, Alexandre" sort="Karras, Alexandre" uniqKey="Karras A" first="Alexandre" last="Karras">Alexandre Karras</name>
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<author><name sortKey="Boutouyrie, Pierre" sort="Boutouyrie, Pierre" uniqKey="Boutouyrie P" first="Pierre" last="Boutouyrie">Pierre Boutouyrie</name>
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<author><name sortKey="Briet, Marie" sort="Briet, Marie" uniqKey="Briet M" first="Marie" last="Briet">Marie Briet</name>
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<author><name sortKey="Bozec, Erwan" sort="Bozec, Erwan" uniqKey="Bozec E" first="Erwan" last="Bozec">Erwan Bozec</name>
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<author><name sortKey="Haymann, Jean Hilippe" sort="Haymann, Jean Hilippe" uniqKey="Haymann J" first="Jean-Philippe" last="Haymann">Jean-Philippe Haymann</name>
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<author><name sortKey="Legendre, Christophe" sort="Legendre, Christophe" uniqKey="Legendre C" first="Christophe" last="Legendre">Christophe Legendre</name>
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<author><name sortKey="Mcmahon, Lawrence P" sort="Mcmahon, Lawrence P" uniqKey="Mcmahon L" first="Lawrence P." last="Mcmahon">Lawrence P. Mcmahon</name>
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<author><name sortKey="Delahousse, Michel" sort="Delahousse, Michel" uniqKey="Delahousse M" first="Michel" last="Delahousse">Michel Delahousse</name>
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<series><title level="j">Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease</title>
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<front><div type="abstract" xml:lang="en"><sec id="jah32467-sec-0001"><title>Background</title>
<p>Chronic kidney disease is characterized by stiffening, thinning, dilatation, and increased circumferential wall stress of large arteries, associated with increased cardiovascular risk. Kidney transplantation (<styled-content style="fixed-case">KT</styled-content>
) reverses many pathological features of chronic kidney disease and improves life expectancy; however, longitudinal studies exploring the impact of <styled-content style="fixed-case">KT</styled-content>
on recipient large arteries are scarce.</p>
</sec>
<sec id="jah32467-sec-0002"><title>Methods and Results</title>
<p>This study was designed to appraise arterial changes following <styled-content style="fixed-case">KT</styled-content>
. 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) (<italic>P</italic>
<0.001). After multivariate adjustment, pulse wave velocity reduction from month 3 to month 12 was significantly larger in the living donor allograft <styled-content style="fixed-case">KT</styled-content>
(<italic>P</italic>
<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 (<italic>P</italic>
<0.001 for all). Reductions in circumferential wall stress, diameter, and stiffness were significantly larger in the living donor allograft <styled-content style="fixed-case">KT</styled-content>
(<italic>P</italic>
<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.</p>
</sec>
<sec id="jah32467-sec-0003"><title>Conclusions</title>
<p>Large‐artery stiffness and maladaptive carotid artery remodeling of chronic kidney disease is partially reversed within 12 months of <styled-content style="fixed-case">KT</styled-content>
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.</p>
</sec>
</div>
</front>
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<tree><noCountry><name sortKey="Boutouyrie, Pierre" sort="Boutouyrie, Pierre" uniqKey="Boutouyrie P" first="Pierre" last="Boutouyrie">Pierre Boutouyrie</name>
<name sortKey="Bozec, Erwan" sort="Bozec, Erwan" uniqKey="Bozec E" first="Erwan" last="Bozec">Erwan Bozec</name>
<name sortKey="Briet, Marie" sort="Briet, Marie" uniqKey="Briet M" first="Marie" last="Briet">Marie Briet</name>
<name sortKey="Delahousse, Michel" sort="Delahousse, Michel" uniqKey="Delahousse M" first="Michel" last="Delahousse">Michel Delahousse</name>
<name sortKey="Haymann, Jean Hilippe" sort="Haymann, Jean Hilippe" uniqKey="Haymann J" first="Jean-Philippe" last="Haymann">Jean-Philippe Haymann</name>
<name sortKey="Karras, Alexandre" sort="Karras, Alexandre" uniqKey="Karras A" first="Alexandre" last="Karras">Alexandre Karras</name>
<name sortKey="Legendre, Christophe" sort="Legendre, Christophe" uniqKey="Legendre C" first="Christophe" last="Legendre">Christophe Legendre</name>
<name sortKey="Mcmahon, Lawrence P" sort="Mcmahon, Lawrence P" uniqKey="Mcmahon L" first="Lawrence P." last="Mcmahon">Lawrence P. Mcmahon</name>
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