Presentation Novel Arterial Vascular Volume Elastic Modulus with Automated Oscillometric Approach Accurately Detected Endothelial and Endothelial Independent Vascular Function in CKD

Yoshinaga , Keiichiro  ,  Tomiyama, Yuuki  ,  Fujii, Satoshi  ,  Nishio, Saori  ,  Naoko Matsuoka  ,  Noriki Ochi  ,  Chietsugu Katoh  ,  Mamiko Inoue  ,  Nishida, Mutumi  ,  M. Ito, Yoichi  ,  Tamaki, Nagara

Background: Simple and automated vascular function measurements are desirable for atherosclerosis risk assessments. Vascular elastic modulus (VE) is uninfluenced by blood pressure and is potentially linked to vascular function. Recently, we developed a novel modality of automated oscillometric method to measure a brachial artery´s VE and estimated arterial cross sectional area (eA). We aimed to investigate whether VE and eA response to nitroglycerin (NTG) reflected endothelial and endothelial independent dysfunction related to chronic kidney disease (CKD). Methods: 13 moderate-to-severe CKD (mean estimated glomerular filtration rate [eGFR]: 29.3±25.7 mL/min/1.73m2) and 15 controls were studied. Rest VE and eA response to NTG were measured by novel automated oscillometric detector. eA was estimated using pressure-volume curves and VE was defined as follows [VE=ΔPressure/ (100XΔarea/Area) mmHg/%]. Ultrasound measurements of flow mediated vasodilatation (FMD) and NTG were used as standard.Results: CKD had lower FMD than control (4.97±3.24 vs 9.03±2.98 %, P=0.002) and attenuated VE (1.09±0.25 vs 0.83±0.17 mmHg/%, P=0.003). Rest Ve was negatively correlated with %FMD(r=-0.43, P=0.02). Percent eA increase after NTG was correlated with %vascular diameter increase with ultrasound(r=0.51, P=0.005). However, there was no difference in %NTG(P=0.16) with ultrasound or %eA change (P=0.34) between the two groups.Conclusions: This new automated vascular function measurement using oscillometric measurement reliably detected endothelial dysfunction related to CKD and has potential to detect endothelial independent vasodilator response.

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