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- OpenAccess
The Association of Pulse Wave Velocity and Ankle- Brachial Index with Left Ventricular Ejection Fraction in Hemodialysis Patients
摘要
BACKGROUND: High pulse wave velocity (PWV) and low ankle brachial index (ABI) are associated with greater cardiovascular disease event rates. In the present study, we examined whether PWV or ABI is associated with low left ventricular ejection fraction (LVEF) in hemodialysis (HD) patients. METHODS: This cross-sectional study attempted to examine the relationship between peripheral artery disease (PAD) and echocardiographically-determined LVEF in a cohort of 180 chronic HD patients. An ABI ＜ 0.9 was used as the criterion for the diagnosis of PAD. Arterial stiffness was measured by PWV. Logistic regression was used to estimate the association between the presence of PAD, other potential risk factors, and LVEF. RESULTS: Of the 180 patients, 53 (29%) had a low, and 127 (71%) had a normal ABI. The mean LVEF increased from the low to normal ABI groups (56.8 ± 10.8 vs. 62.3 ± 7.9; P ＜ 0.001). LVEF levels were positively correlated to ABI values (r = 0.214, P = 0.004), albumin levels (r = 0.218, P = 0.003), and high-density lipoprotein cholesterol (r = 0.205, P = 0.006). LVEF levels were negatively correlated to PWV values (r = -0.206, P = 0.006) and Ln-glucose (r = -0.219, P = 0.003). Multivariate analysis results showed that ABI [β = 8.832; 95% confidence interval (CI), 1.769 to 15.895; P = 0.015] was positively and PWV (β = -0.397; 95% CI, -0.67 to -0.123; P = 0.005) was negatively associated with LVEF. In addition, advanced age, diabetes, increased body mass index, and decreased LVEF were independent factors associated with PAD. CONCLUSIONS: Our findings show that both lower ABI and higher PWV are significantly associated with lower LVEF in HD patients. Screening HD patients by means of ABI and PWV may help to identify a group at high risk for decreased LVEF.
延伸閱讀
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