Pulse Time Index of Norm in aorta during 24-h monitoring in patients with renal transplantation

Background. In recent years, pulse wave velocity (PWV) is recommended as additional test for the evaluation of cardiovascular risk in various patients. The most widely employed methods for evaluating pulse waveforms are those based on applanation tonometry; multi-channel pletysmography, sonography etc. The aim of our study was to assess the feasibility of using an approach to 24-hour pulse wave velocity (PWV) analysis with single-channel sphygmography in the management of patients with renal transplantation. Methods. Overall, 41 patients aged between 18 and 55 years who had end-stage renal disease resulting from glomerulopathy were recruited from the kidney transplant waiting list. All the measurements were performed before kidney transplantation and at 1 and 20 weeks after transplantation. The Pulse Time Index of Norm (PTIN) was calculated with the Vasotens technology for the estimation of the 24-hour PWV, defined as the percentage of the 24-hour period during which the PWV does not exceed 10 m/second. Results. Before kidney transplantation, the mean PTIN in the whole group was 56.3 (standard deviation, 18.4). Then, a week after the renal transplantation, a blood pressure increase and a decrease in the PTIN were observed in most cases, going to 27.6 (standard deviation, 11.1). After 20 weeks, the mean PTIN in the whole group increased again to 52.0 (standard deviation, 23.6). In our study, we found that the persistence of arterial stiffness disturbances after kidney transplantation appears to be relatively predictable. We determined the cutoff value of PTIN that could predict the two states of PTIN: a state of improvement or a state of decline/without change. The cutoff value of PTIN at 45 % had a sensitivity of 69 %, specificity of 76 %, and area under the curve of 0.65. The analysis of variance showed that in the group with an initial PTIN of 45 % or higher, the PTIN in the remote period after transplantation changed significantly (P < 0.05), whereas in the group with an initial PTIN lower than 45 %, there were no significant changes. Conclusion. Thus, the analysis of 24-hour pulse wave velocity in the management of patients with renal transplantation using PTIN is feasible in clinical practice.

трансплантация почки, скорость пульсовой волны, 24-часовое мониторирование, PTIN, renal transplantation, pulse wave velocity, 24-hour monitoring, PTIN

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