Table 3.

Studies demonstrating the association between aortic stiffness and CV mortality assessed by Doppler, mechanotransducer, applanation tonometry and CMR

Author	Population	Age, mean ± SD (years); male sex (%)	Inclusion criteria	Study design	Modality (parameter)	Outcome
Blacher et al. [100]	241 ESRD patients	51.5 ± 16.3; 61	•On HD ≥ 3 months, no pre-existing clinical CVD	•Observational, 6-year mean follow-up	•Doppler ultrasound (cfPWV)	•Patients with the highest cfPWV had increased risk of CV mortality: HR = 5.9 (2.3–15.5). Increased cfPWV (per 1 m/s) gave an RR = 1.39 (1.19–1.62) for all-cause mortality Aortic stiffness was correlated with LVH (r = 0.23, P = 0.0007)
Guerin et al. [101]	150 ESRD patients	52 ± 16; 60	•On HD ≥ 3 months, no clinical CVD preceding	•Prospective cohort, 4.3-year mean follow-up	•Doppler ultrasound (cfPWV)	•Adjusted RR for CV mortality in non-responders was 2.35 (95% CI 1.23–4.51, P < 0.01) compared with responders. For a 1 m/s decrease in PWV in response to BP, RR = 0.79 (95% CI 0.69–0.93) for CV mortality
Shoji et al. [102]	265 ESRD patients (50 had type 2 DM)	55.4 ± 10.5; 41	•On HD ≥ 3 months	•Observational, 5-year mean follow-up	•Mechano-transducer (cfPWV)	•Increased cfPWV (per 1m/s) strongly predicted CV mortality: HR = 1.16 (95% CI 1.0–1.36, P < 0.05), independent of diabetic status
Zoungas et al. [45]	315 Stages 4–5 CKD patientsa	55 ± 13; 67	•Age >18 years, defined CKD, dialysis therapy to start ≤6 months or already established	•Observational, 5.3-year mean follow-up	•Applanation tonometry (cfPWV)	•Increased cfPWV (per 1 m/s) gave a HR = 1.14 (95% CI 1.07–1.26, P < 0.001) for adverse CV outcome •PWV >9.9 m/s gave HR = 3.38 (1.70–6.73, P = 0.001) versus PWV ≤9.9 m/s for CV events.
Mark et al. [62]	144 CKD patients (110 on dialysis)b	51.5 ± 11.2; 62	•CKD: eGFR <15 mL/min/ 1.73 m2	•Prospective observational, 2-year median follow-up	•1.5T CMR (AD)	•AD was associated with CV mortality: HR = 0.135 (95% CI 0.019–0.948, P = 0.044), although diabetes had a stronger association (HR = 4.2)
Verbeke et al. [103]	1084 dialysis patients	68.1; 59	•Age ≥18 years, on HD/PD ≥3 months	•Observational, 2-year follow-up	•Applanation tonometry (cfPWV)	•A PWV >12 m/s gave an HR = 1.94 (95% CI 1.38–2.73). Increased cfPWV (per 1 m/s) gave an HR = 1.15 (95% CI 1.09–1.23, P < 0.001) for CV mortality
Karras et al. [104]	439 CKD patients	59.8 ± 14.5; 74	•Stages 3–5 CKD, not yet on dialysis	•Prospective observational, 4.7-year mean follow-up	•Mechano-transducer (cfPWV)	•Increased cfPWV (per 1 SD) gave an RR = 1.35 (95% CI 1.05–1.75, P = 0.021) for fatal and non-fatal CV events
Baumann et al. [105]	135 CKD patients	59.2 ± 15.1; 46	•Stages 2–4 CKD	•Prospective observational, 3.7-year mean follow-up	•Oscillometric method (PWV)	•PWV >10 m/s gave an OR = 5.1 (95% CI 1.1–22.9, P < 0.05)
Sulemane et al. [106]	106 CKD patients	55.9 ± 2.8; 51	•No overt CVD, normal LV ejection fraction, not on HD	•Prospective observational, 4-year median follow-up	•Applanation tonometry (cfPWV)	•Increased cfPWV (per 1 m/s) gave an HR = 1.31 (95% CI 1.05–1.41, P = 0.021)

HD, haemodialysis; DM, diabetes mellitus; HR, hazard ratio; OR, odds ratio; RR, risk ratio; 95% confidence intervals presented in brackets.

^a207 had cfPWV assessment.

^b122 patients had AD analysed.