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Open AccessArticle

Upstroke Time as a Novel Predictor of Mortality in Patients with Chronic Kidney Disease

1
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
2
Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 812, Taiwan
3
Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
4
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(6), 422; https://doi.org/10.3390/diagnostics10060422
Received: 11 May 2020 / Revised: 17 June 2020 / Accepted: 18 June 2020 / Published: 20 June 2020
(This article belongs to the Section Medical Imaging)
Upstroke time (UT), measured from the foot-to-peak peripheral pulse wave, is a merged parameter used to assess arterial stiffness and target vascular injuries. In this study, we aimed to investigate UT for the prediction of cardiovascular and all-cause mortality in patients with chronic kidney disease (CKD). This longitudinal study enrolled 472 patients with CKD. Blood pressure, brachial pulse wave velocity (baPWV), and UT were automatically measured by a Colin VP-1000 instrument. During a median follow-up of 91 months, 73 cardiovascular and 183 all-cause mortality instances were recorded. Multivariable Cox analyses indicated that UT was significantly associated with cardiovascular mortality (hazard ratio (HR) = 1.010, p = 0.007) and all-cause mortality (HR = 1.009, p < 0.001). The addition of UT into the clinical models including traditional risk factors and baPWV further increased the value in predicting cardiovascular and all-cause mortality (both p < 0.001). In the Kaplan–Meier analyses, UT ≥ 180 ms could predict cardiovascular and all-cause mortality (both log-rank p < 0.001). Our study found that UT was a useful parameter in predicting cardiovascular and all-cause mortality in CKD patients. Additional consideration of the UT might provide an extra benefit in predicting cardiovascular and all-cause mortality beyond the traditional risk factors and baPWV. View Full-Text
Keywords: upstroke time; pulse wave velocity; blood pressure; mortality; chronic kidney disease upstroke time; pulse wave velocity; blood pressure; mortality; chronic kidney disease
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Lee, W.-H.; Hsu, P.-C.; Chu, C.-Y.; Chen, S.-C.; Chen, Y.-C.; Lee, M.-K.; Lee, H.-H.; Lee, C.-S.; Yen, H.-W.; Lin, T.-H.; Voon, W.-C.; Lai, W.-T.; Sheu, S.-H.; Su, H.-M. Upstroke Time as a Novel Predictor of Mortality in Patients with Chronic Kidney Disease. Diagnostics 2020, 10, 422.

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