PMID- 25264363 OWN - NLM STAT- MEDLINE DCOM- 20160502 LR - 20220318 IS - 1097-6809 (Electronic) IS - 0741-5214 (Print) IS - 0741-5214 (Linking) VI - 63 IP - 1 DP - 2016 Jan TI - Adipose phenotype predicts early human autogenous arteriovenous hemodialysis remodeling. PG - 171-6.e1 LID - S0741-5214(14)01279-8 [pii] LID - 10.1016/j.jvs.2014.06.110 [doi] AB - OBJECTIVE: Substantial proportions of autogenous arteriovenous fistulas (AVFs) for hemodialysis access fail to mature for unclear reasons. AVFs develop in a large mass of surrounding adipose tissue that is increasingly recognized as an active participant in the vascular response to injury via paracrine and endocrine mechanisms. We thus hypothesized that baseline phenotypic characteristics of the adipose tissue juxtaposed to the developing AVF associate with subsequent inward or outward vein wall remodeling. METHODS: Clinical data and subcutaneous adipose tissue were collected from 22 consented patients undergoing AVF creation. Tissue was assayed (protein levels) for interleukin (IL)-6, IL-8, leptin, tumor necrosis factor-alpha, monocyte chemoattractant protein-1 (MCP-1), resistin, and adiponectin. Vein dimensions were acquired by duplex ultrasound imaging, preoperatively and at 4 to 6 weeks postoperatively, 1 cm cephalad to the arteriovenous anastomosis, which is the most common location of AVF stenosis). RESULTS: The vein at the assayed location outwardly remodeled 55.7% on average (median before, 3.7 mm; median after, 4.7 mm; P = .005). The preoperative vein diameter failed to correlate with postoperative size at the point of assay (R = 0.31; P = .155) unless two outliers were excluded (R = 0.64; P = .002). After removal of the same outliers, the correlation coefficient between venous diameter change (preoperative vs postoperative) and IL-8, tumor necrosis factor-alpha, MCP-1, resistin, and adiponectin was -0.49, -0.79, -0.66, -0.64, and -0.69, respectively (P < .05). Postoperative AVF flow volume correlated with MCP-1 (R = -0.53; P < .05) and adiponectin (R = -0.47; P < .05). CONCLUSIONS: These data reveal a novel relationship between local adipose phenotype and the eventual venous wall response to hemodynamic perturbation in humans. The predictive value of these mediators generally equaled or exceeded that of preoperative vein size. Beyond providing mechanistic insights into vascular wall adaptations due to flow perturbations, this discovery suggests that strategies focused on altering adipose tissue biology may improve AVF maturation. CI - Copyright (c) 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Mauro, Christine R AU - Mauro CR AD - Department of Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. FAU - Ding, Kui AU - Ding K AD - Department of Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang, China. FAU - Xue, Hui AU - Xue H AD - Department of Medicine, Division of Nephrology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. FAU - Tao, Ming AU - Tao M AD - Department of Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. FAU - Longchamp, Alban AU - Longchamp A AD - Department of Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. FAU - Belkin, Michael AU - Belkin M AD - Department of Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. FAU - Kristal, Bruce S AU - Kristal BS AD - Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. FAU - Ozaki, C Keith AU - Ozaki CK AD - Department of Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. Electronic address: ckozaki@partners.org. LA - eng GR - F32 HL117521/HL/NHLBI NIH HHS/United States GR - R01 HL133500/HL/NHLBI NIH HHS/United States GR - T32-HL-007734/HL/NHLBI NIH HHS/United States GR - F32-HL-117521/HL/NHLBI NIH HHS/United States GR - T32 HL007734/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Observational Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20140926 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 RN - 0 (Biomarkers) SB - IM MH - Aged MH - Arteriovenous Shunt, Surgical/*adverse effects MH - Biomarkers/metabolism MH - Female MH - Graft Occlusion, Vascular/diagnosis/*etiology/metabolism/physiopathology MH - Hemodynamics MH - Humans MH - Male MH - Middle Aged MH - Phenotype MH - Prospective Studies MH - *Renal Dialysis MH - Risk Factors MH - Subcutaneous Fat/*metabolism MH - Time Factors MH - Treatment Failure MH - Ultrasonography, Doppler, Pulsed MH - *Vascular Remodeling MH - Veins/diagnostic imaging/physiopathology/*surgery PMC - PMC4377114 MID - NIHMS611069 COIS- Conflict of interest: The authors declare no conflict of interest. EDAT- 2014/09/30 06:00 MHDA- 2016/05/03 06:00 PMCR- 2017/01/01 CRDT- 2014/09/30 06:00 PHST- 2014/04/08 00:00 [received] PHST- 2014/06/12 00:00 [accepted] PHST- 2014/09/30 06:00 [entrez] PHST- 2014/09/30 06:00 [pubmed] PHST- 2016/05/03 06:00 [medline] PHST- 2017/01/01 00:00 [pmc-release] AID - S0741-5214(14)01279-8 [pii] AID - 10.1016/j.jvs.2014.06.110 [doi] PST - ppublish SO - J Vasc Surg. 2016 Jan;63(1):171-6.e1. doi: 10.1016/j.jvs.2014.06.110. Epub 2014 Sep 26.