Investigation of the Relationship between Cardiovascular Biomarkers and Brachial-Ankle Pulse Wave Velocity in Hemodialysis Patients

Abstract

Brachial−ankle pulse wave velocity (baPWV) and cardiovascular (CV) biomarkers are correlated with clinical cardiovascular diseases (CVDs) in patients with kidney disease. However, limited studies evaluated the relationship between baPWV and CV biomarkers in hemodialysis patients. This study investigated the relationship between circulating CV biomarkers and baPWV in patients on hemodialysis. Hemodialysis patients were enrolled between August 2016 and January 2017 for the measurement of baPWV, traditional CV biomarkers, including high-sensitivity troponin-T (hsTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), and novel CV biomarkers, including Galectin-3, Cathepsin D, placental growth factor, Endocan-1, and Fetuin-A. The independent association was assessed by multivariate-adjusted linear regression analysis to control for potential confounders. The final analysis included 176 patients (95 men and 81 women) with a mean age of 60 ± 11 y old. After adjusting for age and sex, hsTnT (p < 0.01), NT-proBNP (p = 0.01), Galectin-3 (p = 0.03), and Cathepsin D (p < 0.01) were significantly directly correlated with baPWV. The direct correlation with baPWV existed in multivariable linear regression models with a β of 0.1 for hsTnT and 0.1 for Cathepsin D. The direct relationship between baPWV and CV biomarkers, particularly with hsTnT and Cathepsin D, may be helpful for risk stratification of hemodialysis patients.

Keywords: brachial–ankle pulse wave velocity (baPWV); cardiovascular (CV) biomarkers; hemodialysis.

Figure 1

Sample derivation flowchart.

Figure 2

Scatter plots with spline lines demonstrated selected CV biomarkers’ direct association with brachial–ankle pulse wave velocity in hemodialysis patients: (A) high-sensitivity troponin T (r = 0.5, p < 0.01); (B) N-terminal pro-brain natriuretic peptide (r = 0.2, p = 0.01); (C) Galectin 3 (r = 0.1, p = 0.1); (D) Cathepsin D (r = 0.2, p < 0.01).

Figure 3

The mean values of CV biomarkers in quartile groups of brachial–ankle pulse wave velocity among hemodialysis patients: (A) high-sensitivity troponin T (p for trend < 0.01); (B) N-terminal pro-brain natriuretic peptide (p for trend 0.01); (C) Galectin 3 (p for trend = 0.12); (D) Cathepsin D (p for trend = 0.02). Multiple comparisons were performed by Dunn’s multiple comparison test (a. significant difference from Q1; b. significant difference from Q2). Statistical significance was defined as p < 0.05.