Associations Between Renal Duplex Parameters and Adverse Cardiovascular Events in the Elderly: A Prospective Cohort Study

摘要: Background Atherosclerotic renovascular disease is associated with an increased risk of cardiovascular (CVD) events. This study examines associations between Doppler-derived parameters from the renal artery and parenchyma all-cause mortality fatal nonfatal CVD events in a cohort elderly Americans. Study Design Cohort study. Setting A subset participants Cardiovascular Health (CHS). Through ancillary study, 870 (70% recruitment) Forsyth County, NC, CHS consented to undergo duplex sonography define prevalence elderly, resulting 726 (36% men; mean age, 77 years) technically adequate complete studies included this investigation. Predictor Renal sonography–derived Doppler signals main arteries parenchyma. Spectral analysis Doppler-shifted frequencies angle insonation were used estimate peak systolic end diastolic velocity (both meters per second). Color was identify corticomedullary junction. Using 3-mm sample, parenchymal frequency shift kilohertz) obtained. Resistive index calculated as (1 − [end shift/peak shift]) using samples hilar left or right kidney higher velocity. Outcomes & Measurements Proportional hazard regression determine adjusted for accepted factors. Index outcomes defined coronary (angina, myocardial infarction, bypass grafting/percutaneous intervention), cerebrovascular (stroke transient ischemic attack), any event congestive heart failure, stroke, attack, grafting [CABG]/percutaneous transluminal intervention [PTCI]). Results During follow-up, 221 deaths (31%), 229 (32%), 122 (17%), 92 (13%) observed. independently outcomes. In particular, significantly (HR, 0.73; 95% CI, 0.62-0.87; P = 0.06) decreased 0.78; 0.61-1.01; 0.06). Parenchymal not predictive 0.84; 0.67-1.06; 0.1). Limitations showed "healthy cohort" effect that may underestimate rate general population. Conclusion sonographic significant subsequent after controlling other standard deviation increase 27% reduction event.