Miseljic Sanja, Aziri Buena, Begic Edin, Rebic Damir, Džubur Alen, Miseljic Nenad, Mekic Mevludin, Resic Halima, Begic Nedim, Zukic Fuad
Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Deparment of Pharmacology, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina.
Int J Appl Basic Med Res. 2022 Oct-Dec;12(4):269-276. doi: 10.4103/ijabmr.ijabmr_197_22. Epub 2022 Dec 19.
The study aimed to evaluate the acute effect of ultrafiltration on the mechanical properties of the aorta using brachial-ankle pulse wave velocity (PWV) before and after hemodialysis (HD).
This study included 80 patients who were on a long-term HD program. The input variables were anamnestic data, body composition monitor (BCM) parameters, and echocardiography findings. The assessment of hydration status was determined by BCM, whose work is based on the principle of multifrequency bioimpedance spectroscopy. Another diagnostic procedure was the use of an arteriograph apparatus to assess PWV and Augmentation Index (AIx). All measurements were performed before and after dialysis on the middle dialysis day of the week.
The participants were divided into two groups based on hydration status: the experimental group consisted of 40 overhydrated participants and the control group consisted of 40 normovolemic participants. Statistically, the following BCM parameters correlated significantly positively with PWV: total body fat ( = 0.222; < 0.05), overhydration ( = 0.290; < 0.001), and relative overhydration ( = 0.290; < 0.001). From echocardiography findings, only left atrial diameter correlated statistically significantly positively with PWV ( = 0.359; < 0.001). Comparison of the mean PWV values within the experimental group before and after HD showed a statistically significant decrease from 14.32 ± 2.34 m/s to 8.72 ± 1.52 m/s ( = 3.254; = 0.0001). Mean PWV values within the control group did not decrease significantly from 13.39 ± 1.32 m/s to 10.39 ± 1.18 m/s ( = 0.524; = 0.742). If we compare the mean values of PWV between groups, then before HD treatment, there was no statistically significant difference between groups with PWV values in the experimental group of 14.32 ± 2.34 m/s and the control group of 13.39 ± 1.32 m/s ( = 0.762; = 0.852). According to the results of univariate regression analysis before and after HD treatment, only overhydration showed an absolute effect on PWV before and after HD.
Overhydration showed an effect on brachial-ankle PWV before and after HD, and brachial-ankle PWV should be followed in HD patients.
本研究旨在通过评估血液透析（HD）前后的肱踝脉搏波速度（PWV），来评价超滤对主动脉力学性能的急性影响。
本研究纳入了80例长期接受血液透析治疗的患者。输入变量包括既往史数据、人体成分监测仪（BCM）参数和超声心动图检查结果。通过BCM评估水化状态，其工作基于多频生物电阻抗光谱原理。另一项诊断程序是使用动脉造影仪评估PWV和增强指数（AIx）。所有测量均在一周中间的透析日透析前后进行。
根据水化状态将参与者分为两组：实验组由40例水负荷过重的参与者组成，对照组由40例血容量正常的参与者组成。统计学上，以下BCM参数与PWV呈显著正相关：全身脂肪（r = 0.222；P < 0.05）、水负荷过重（r = 0.290；P < 0.001）和相对水负荷过重（r = 0.290；P < 0.001）。从超声心动图检查结果来看，只有左心房直径与PWV在统计学上呈显著正相关（r = 0.359；P < 0.001）。实验组HD前后平均PWV值比较显示，从14.32±2.34米/秒显著降至8.72±1.52米/秒（t = 3.254；P = 0.0001）。对照组平均PWV值从13.39±1.32米/秒降至10.39±1.18米/秒，无显著下降（t = 0.524；P = 0.742）。如果比较两组之间的PWV平均值，那么在HD治疗前，实验组PWV值为14.32±2.34米/秒，对照组为13.39±1.32米/秒，两组之间无统计学显著差异（t = 0.762；P = 0.852）。根据HD治疗前后的单因素回归分析结果，只有水负荷过重对HD前后的PWV有绝对影响。
水负荷过重对HD前后的肱踝PWV有影响，HD患者应监测肱踝PWV。
