Association between environmental particulate matter and arterial stiffness in patients undergoing hemodialysis

BMC Cardiovascular Disorders, Oct 2015

Background Aortic pulse wave velocity (PWV) has been shown to be an independent predictor of cardiovascular mortality in patients with end-stage renal disease and the general population. Atmospheric particulate- matter (PM) concentrations and their effects on cardiovascular system by affecting arterial stiffness and central hemodynamic parameters had been noted. The purpose of this study was to access the correlation of air pollution variables and PWV in patients undergoing hemodialysis (HD). Methods This study analyzed 127 HD patients treated at the outpatient HD center. Brachial-ankle pulse wave velocity (baPWV) was measured by using a Vascular Profiler 1000 (VP-1000). Air pollution levels were recorded by a network of 27 monitoring stations near or in the patients’ living areas throughout Taiwan. The 12-month average concentrations of PM with an aerodynamic diameter of <10 and <2.5 mm (PM 10 and PM 2.5 , respectively), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), carbon monoxide(CO), and ozone (O 3 ) were included. Results and Discussion Multivariate linear regression analyses indicated that systolic blood pressure (SBP) (β = 0.589, P < 0.025), age (β = 0.316, P < 0.001), serum aluminum level (Al) (β = 0.149, P = 0.020), and PM 10 (β = 0.133, P = 0.036) were positively correlated with baPWV. Conclusion This cross-sectional study shows that in HD patients, the environmental PM 10 level is associated with the baPWV.

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Association between environmental particulate matter and arterial stiffness in patients undergoing hemodialysis

Weng et al. BMC Cardiovascular Disorders Association between environmental particulate matter and arterial stiffness in patients undergoing hemodialysis Cheng-Hao Weng 0 1 Ching-Chih Hu 0 2 Tzung-Hai Yen 0 1 Wen-Hung Huang 0 1 0 College of Medicine, Chang Gung University , Taoyuan , Taiwan 1 Department of Nephrology, Chang Gung Memorial Hospital , Linkou, 5 Fu-Shin Street, Kwei-Shan 333, Taoyuan , Taiwan 2 Department of Hepatogastroenterology and Liver Research Unit, Chang Gung Memorial Hospital , Keelung , Taiwan Background: Aortic pulse wave velocity (PWV) has been shown to be an independent predictor of cardiovascular mortality in patients with end-stage renal disease and the general population. Atmospheric particulate- matter (PM) concentrations and their effects on cardiovascular system by affecting arterial stiffness and central hemodynamic parameters had been noted. The purpose of this study was to access the correlation of air pollution variables and PWV in patients undergoing hemodialysis (HD). Methods: This study analyzed 127 HD patients treated at the outpatient HD center. Brachial-ankle pulse wave velocity (baPWV) was measured by using a Vascular Profiler 1000 (VP-1000). Air pollution levels were recorded by a network of 27 monitoring stations near or in the patients' living areas throughout Taiwan. The 12-month average concentrations of PM with an aerodynamic diameter of <10 and <2.5 mm (PM10 and PM2.5, respectively), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide(CO), and ozone (O3) were included. Results and Discussion: Multivariate linear regression analyses indicated that systolic blood pressure (SBP) (β = 0.589, P < 0.025), age (β = 0.316, P < 0.001), serum aluminum level (Al) (β = 0.149, P = 0.020), and PM10 (β = 0.133, P = 0.036) were positively correlated with baPWV. Conclusion: This cross-sectional study shows that in HD patients, the environmental PM10 level is associated with the baPWV. Hemodialysis; Pulse wave velocity; Particulate matter - Background Patients with end-stage renal disease undergoing hemodialysis (HD) have high rates of morbidity and mortality. Cardiovascular diseases account for almost half of this mortality [1]. Aortic pulse wave velocity (PWV) has been shown to be an independent predictor of cardiovascular mortality in patients with end-stage renal disease and the general population [2]. Brachial-ankle pulse wave velocity (baPWV) is an accurate indicator of aortic PWV measured by intra-aortic catheter by volume-rendering [3]. We have previous shown that serum aluminum level (Al) was positively associated with baPWV after correction of other known risk factors [4]. Adamopoulos et al. [5] analyzed the atmospheric pollution variables, including atmospheric particulate- matter (PM) concentrations and their effects on cardiovascular system by affecting arterial stiffness and central hemodynamic parameters, and found that in men, PM10 air pollution levels were associated with heightened amplitude of PWV. Our recently study also showed that variables of air pollution levels were associated with 2-year mortality, level of high sensitivity C-reactive protein (hsCRP), and dialysis related infections in patients undergoing peritoneal dialysis [6–8]. The purpose of this study was to access the correlation of air pollution variables and baPWV in patients undergoing HD, which had never been studied before. © 2015 Weng et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Methods Ethics statement This study complied with the guidelines of the Declaration of Helsinki and was approved by the Medical Ethics Committee of Chang Gung Memorial Hospital (Institutional Review Board approval number: 101-5199B), a tertiary referral center located in the northern part of Taiwan. Written informed consent for this cross-sectional and publication of these data were obtained from every patient. All data were protected securely and only available to researchers; the data were also analyzed without patients’ names. Subjects One hundred and thirty eight HD patients treated at the outpatient HD center at Chang Gung Memorial Hospital in Taoyuan, Taiwan were analyzed. To diagnose peripheral arterial occlusive disease (PAOD), the ankle-brachial blood pressure index (ABPI) was developed. PAOD has a reliable and accepted marker, which is when ABPI is less than 0.9. Severe PAOD decreases baPWV due to decreased internal pressure and blood flow. Therefor (...truncated)


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Cheng-Hao Weng, Ching-Chih Hu, Tzung-Hai Yen, Wen-Hung Huang. Association between environmental particulate matter and arterial stiffness in patients undergoing hemodialysis, BMC Cardiovascular Disorders, 2015, pp. 115, 15, DOI: 10.1186/s12872-015-0107-0