P.19 Intradialytic Changes in Cerebral Blood Flow and Regional Changes in Arterial Stiffness

Mathilde Paré; Hasan Obeid; Lawrence Labrecque; Audrey Drapeau; Karine Marquis; Patrice Brassard; Mohsen Agharazii

doi:10.2991/artres.k.201209.032

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Volume 26, Issue Supplement 1, December 2020, Pages S41 - S41

P.19 Intradialytic Changes in Cerebral Blood Flow and Regional Changes in Arterial Stiffness

Authors

Mathilde Paré¹^{, 2}^{, 3}^{, 4}^{, *}, Hasan Obeid¹^{, 2}^{, 5}^{, 6}, Lawrence Labrecque³^{, 4}, Audrey Drapeau³^{, 4}, Karine Marquis¹^{, 2}, Patrice Brassard³^{, 4}, Mohsen Agharazii¹^{, 2}

¹CHU de Québec Research Center, L’Hôtel-Dieu de Québec

²Division of Nephrology, Faculty of Medicine, Université Laval

³Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec

⁴Department of Kinesiology, Faculty of Medicine, Université Laval

⁵INSERM, UMR-970, Paris Cariovascular Research Center, 75015

⁶AP-HP, Pharmacology Unit, Hôpital Européen Georges Pompidou, Université de Paris

^*Corresponding author. Email: mathilde.pare.1@crchudequebec.ulaval.ca

Corresponding Author

Mathilde Paré

Available Online 31 December 2020.

DOI: 10.2991/artres.k.201209.032 How to use a DOI?
Keywords: Arterial stiffness; flow pulsatility
Abstract: Purpose/Background/Objective: Cognitive decline is highly prevalent amongst end-stage renal disease (ESRD) patients and is accelerated upon initiation of hemodialysis (HD) [1]. ESRD increases aortic stiffness and blood flow pulsatility, which may damage small vessels of target organs like the brain [2]. In this pilot study, we aimed to evaluate the acute effect of HD on cerebral blood flow and its relation to arterial stiffness.

Methods: Before, every hour during and after HD (T0–T4), we measured cerebral flow velocity (FV) using transcranial Doppler, blood pressure (BP) via digital finger cuff (Nexfin), cardiac activity using ECG and aortic pulse wave velocity (PWV) with Mobile-O-Graph. FV pulsatility index (PI) and transit times between ECG peak and the foot of both FV and BP waveforms (cerebral dT; digital dT) were computed using in house MATLAB-based analysis. Changes during HD were evaluated with Generalized Estimating Equation models adjusting for multiple comparisons in SPSS 26.0.

Results: In eight participants aged 63 ± 17 y. old (4 diabetics, 3 women), peak FV decreased from baseline at T1 and T2 (−11.2 cm/s, p = 0.007; −12.2 cm/s, p < 0.001), PI decreased at T1 (0.81 to 0.77, p = 0.005), whilst minimum FV, mean BP and partial pressure of CO₂ remained unchanged. Digital dT increased at T3 (0.19 to 0.22, p < 0.001) and cerebral dT increased throughout HD (T1–T4, p < 0.005), whereas aortic PWV did not change.

Conclusions: During hemodialysis, cerebral and digital transit times increased, suggesting decreased stiffness of small peripheral vessels, without significant changes in aortic stiffness. Reduced stiffness of cerebral arteries may partially explain decreased cerebral flow pulsatility.
Copyright: © 2020 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

REFERENCES

[1]AR Zammit, MJ Katz, M Bitzer, and RB Lipton, Cognitive impairment dementia in older adults with chronic kidney disease: a review, Alzheimer Dis Assoc Disord, Vol. 30, 2016, pp. 357-66.

[2]P Toth, S Tarantini, A Csiszar, and Z Ungvari, Functional vascular contributions to cognitive impairment and dementia: mechanisms and consequences of cerebral autoregulatory dysfunction, endothelial impairment, and neurovascular uncoupling in aging, Am J Physiol Heart Circ Physiol, Vol. 312, 2017, pp. H1-H20.

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Journal: Artery Research
Volume-Issue: 26 - Supplement 1
Pages: S41 - S41
Publication Date: 2020/12/31
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.2991/artres.k.201209.032 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

ris enw bib

TY  - JOUR
AU  - Mathilde Paré
AU  - Hasan Obeid
AU  - Lawrence Labrecque
AU  - Audrey Drapeau
AU  - Karine Marquis
AU  - Patrice Brassard
AU  - Mohsen Agharazii
PY  - 2020
DA  - 2020/12/31
TI  - P.19 Intradialytic Changes in Cerebral Blood Flow and Regional Changes in Arterial Stiffness
JO  - Artery Research
SP  - S41
EP  - S41
VL  - 26
IS  - Supplement 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.201209.032
DO  - 10.2991/artres.k.201209.032
ID  - Paré2020
ER  -

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