Impact of kidney transplantation on aortic stiffness and aortic stiffness index β0

Marie-Pier Desjardins, Aboubacar Sidibé, Catherine Fortier, Fabrice Mac-Way, Sacha De Serres, Richard Larivière, Bart Spronck, Rémi Goupil, Mohsen Agharazii*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Web of Science)

Abstract

BACKGROUND: In chronic kidney disease, the enhanced aortic stiffness increases risk of cardiovascular events. Kidney transplantation (KTx) may improve aortic stiffness; however, it is unclear whether the improvement of aortic stiffness is merely the outcome of the reduction of blood pressure (BP) post-KTx. Furthermore, the long-term trajectory of aortic stiffness remains uncertain, as activation of the immune system may have a negative long-term impact on arterial wall property.

METHOD: Using aortic stiffness β0 as a BP-independent stiffness parameter, and a statistical adjustment for BP, we aimed to examine the early vs. late changes in aortic stiffness, and to define the characteristics of patients with favourable and unfavourable long-term trajectories of aortic stiffness. In this longitudinal study, aortic stiffness was assessed before, 3, 6 and 24 months after KTx in 79 individuals. Aortic stiffness was determined by carotid-femoral pulse wave velocity (cf-PWV), and aortic stiffness index β0 was obtained by applying the stiffness parameter β0 theory to cf-PWV based on Bramwell-Hill's equation using a reference pressure.

RESULTS: There was an early reduction of β0 3 months after KTx (29.0 ± 2.0 to 25.8 ± 1.2, P = 0.033) followed by a gradual increase at 6 (28.0 ± 1.4, P = 0.005 vs. 3 months) and 24 months (28.3 ± 1.3, P = 0.003 vs. 3 months). A late increase in β0 was associated with higher levels of the interleukin-6 (P = 0.029) even after adjustment for potential cofounders. Using statistical adjustments for BP showed similar results.

CONCLUSION: Reduction of aortic stiffness index β0 3 months after KTx suggests that KTx leads to an early de-stiffening of the intrinsic mechanical properties of aorta. However, this improvement is followed by a later stiffening, which is associated with increased interleukin-6, suggesting that activation of the immune system may be involved in arterial wall remodelling in kidney recipients.

Original languageEnglish
Pages (from-to)1521-1528
Number of pages8
JournalJournal of Hypertension
Volume37
Issue number7
DOIs
Publication statusPublished - Jul 2019
Externally publishedYes

Keywords

  • Adult
  • Aged
  • Aorta/physiology
  • Arteries/physiology
  • Blood Pressure
  • Female
  • Humans
  • Interleukin-6/blood
  • Kidney Transplantation
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Postoperative Complications
  • Pulse Wave Analysis
  • Risk Factors
  • Stress, Mechanical
  • Vascular Stiffness
  • chronic kidney disease
  • aortic stiffness index beta 0
  • kidney transplantation
  • BLOOD-PRESSURE
  • OXIDATIVE STRESS
  • CARDIOVASCULAR EVENTS
  • RISK
  • INTERLEUKIN-6
  • aortic stiffness
  • ARTERIAL STIFFNESS
  • INFLAMMATION
  • DISEASE
  • ASSOCIATION
  • EPIDEMIOLOGY

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