Artery Research

Volume 5, Issue 4, December 2011, Pages 140 - 141

3.2 SPECTRAL ANALYSIS OF CAROTID DISTENSION RATE AND R–R INTERVAL (SPONTANEOUS BAROREFLEX ACTIVITY) PREDICTS CORONARY HEART DISEASE RISK IN PATIENTS WITH MODERATE CHRONIC KIDNEY DISEASE AND IN THOSE WITH NORMAL RENAL FUNCTION: THE EPP3 STUDY

Authors
L. Zanoli1, 2, M. Alivon1, J.P. Empana1, N. Estrugo1, G. Ecriou1, H. Ketthab1, J.F. Pruny1, P. Castellino2, S. Yanes1, D. Laude1, K. Bean1, F. Thomas3, X. Jouven1, S. Laurent1, P. Boutouyrie1
1Université Paris Descartes, Department of Pharmacology, HEGP, APHP, Paris, France
2University of Catania, Department of Internal Medicine, Catania, Italy
3Institut Prévention cardiovasculaire, Paris, France
Available Online 29 November 2011.
DOI
10.1016/j.artres.2011.10.214How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

The classic technique to evaluate the spontaneous baroreflex is the spectral analysis of finger blood pressure and heart rate. However, baroreceptors respond to deformation and not to pressure per se and the results obtained with this technique can be influenced by the vascular component of the baroreflex. Recently, the spectral analysis of carotid distension rate has been used to study the neural baroreflex. The aim of this study is to test this new technique to predict the coronary heart disease (CHD) risk in patients with moderate chronic kidney disease (CKD) and in those with normal renal function.

Methods: From the cohort of EPP3 study, 2211 patients were included in this report (age 59±6 years). The baroreceptor sensitivity (BRS) was defined as the ratio between variations in the carotid distension rate and variations in R-R interval in the low-frequency range (0.04–0.15Hz). The CHD risk was estimated according to the Framingham risk score.

Results: We studied 2088 patients with GFR>60ml/min/1.73m2 and 123 patients with CKD (GFR 45–60ml/min/1.73m2). The prevalence of 10 years CHD risk≥20% was significantly higher in patients with CKD than in those with normal renal function (30% and 14%, respectively). In fully adjusted model, in the total population, the increase of BSA, IMT and carotid PP, the reduction of carotid strain and BRS, and the presence of CKD were independently associated with 10 years CHD risk≥20% (Table 1).

Conclusions: The spontaneous BRS is a predictor of CHD risk in patients with moderate CKD and in those with normal renal function.

Predictors of 10 years CHD risk ≥ 20% OR 95%CI P value
Body surface area, m2 × 10−1 1.20 1.13–1.27 <0.001
Intima-media thickness, μm × 102 1.29 1.16–1.43 <0.001
Carotid pulse pressure, 10 mm Hg 1.62 1.47–1.79 <0.001
Carotid strain, % 0.80 0.74–0.86 <0.001
Baroreflex sensitivity, Log [(ms/(μm/s)2) × 102] 0.36 0.23–0.59 <0.001
Moderate chronic kidney disease 2.15 1.38–3.37 <0.001
Journal
Artery Research
Volume-Issue
5 - 4
Pages
140 - 141
Publication Date
2011/11/29
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2011.10.214How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - L. Zanoli
AU  - M. Alivon
AU  - J.P. Empana
AU  - N. Estrugo
AU  - G. Ecriou
AU  - H. Ketthab
AU  - J.F. Pruny
AU  - P. Castellino
AU  - S. Yanes
AU  - D. Laude
AU  - K. Bean
AU  - F. Thomas
AU  - X. Jouven
AU  - S. Laurent
AU  - P. Boutouyrie
PY  - 2011
DA  - 2011/11/29
TI  - 3.2 SPECTRAL ANALYSIS OF CAROTID DISTENSION RATE AND R–R INTERVAL (SPONTANEOUS BAROREFLEX ACTIVITY) PREDICTS CORONARY HEART DISEASE RISK IN PATIENTS WITH MODERATE CHRONIC KIDNEY DISEASE AND IN THOSE WITH NORMAL RENAL FUNCTION: THE EPP3 STUDY
JO  - Artery Research
SP  - 140
EP  - 141
VL  - 5
IS  - 4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2011.10.214
DO  - 10.1016/j.artres.2011.10.214
ID  - Zanoli2011
ER  -