Altered Central Haemodynamic Parameters Derived From Reservoir Pressure Analysis: Association With Biomarkers Of Target Organ Damage In Older Adults

Objective: Altered central haemodynamics assessed by reservoir pressure analysis (RPA) could have a detrimental effect on target organs like the kidneys and heart. In this cross-sectional study, we aimed to determine whether RPA parameters would be associated with biomarkers of renal and cardiac damage in older adults. Design and method: We studied 689 individuals (69.1 ± 8.1yrs, 214F, 255CVD). RPA parameters including reservoir pressure integral (INTPR), excess pressure integral (INTXSP), systolic and diastolic rate constants (SRC and DRC, respectively) were calculated from radial artery tonometry. Urinary albumin-to-creatinine ratio (UACR) and N-terminal pro-brain-type natriuretic peptide (NT-proBNP) were measured as renal and cardiac biomarkers, respectively. Results: After accounting for conventional risk factors and estimated glomerular filtration rate (eGFR), UACR was independently associated with INTPR [B = −0.130 (95%CI: -0.190, −0.007)], INTXSP [B = 0.420 (95%CI: 0.039, 0.801)] and DRC [B = 0.352 (95%CI: 0.086, 0.617)] when analyzed separately. In a multivariable model including all RPA parameters and adjusted for risk factors and eGFR, UACR was independently associated with INTXSP [B = 0.663 (95%CI: 0.366, 0.959)] and DRC [B = 0.399 (95%CI: 0.139, 0.658)]. When analysed separately, NT-proBNP was independently associated with INTXSP [B = 0.732 (95%CI: 0.526, 0.938)], SRC [B = −0.235 (95%CI: −0.461, −0.010)] and DRC [B = 0.402 (95%CI: 0.201, 0.603)] after accounting for risk factors and eGFR. NT-proBNP was independently associated with INTXSP [B = 0.635 (95%CI: 0.427, 0.842)] and DRC [B = 0.426 (95%CI: 0.231, 0.620)] in a multivariable model including all RPA parameters and adjusted for risk factors and eGFR. Further adjustments for central artery stiffness and aortic systolic pressure did not alter the findings. Conclusions: These results demonstrate that INTXSP and DRC are independently associated with biomarkers of renal and cardiac damage in older adults, suggesting that altered reservoir function could contribute to deterioration of these organs.