TY - JOUR
T1 - Hemodynamic index of atheromatous renal artery stenosis for angioplasty
AU - Tanemoto, Masayuki
AU - Suzuki, Takehiro
AU - Abe, Michiaki
AU - Abe, Takaaki
AU - Ito, Sadayoshi
PY - 2009/3/1
Y1 - 2009/3/1
N2 - Background and objectives: Trans-stenotic pressure gradient across the constriction (PG), a hemodynamic variable of atheromatous renal artery stenosis (ARAS), is a widely used indicator for angioplasty, but its association with the outcome of angioplasty has not been fully investigated. Design, setting, participants & measurements: In 34 hypertensive cases with unilateral ARAS, we evaluated hemodymanic variables of ARAS with reference to the systemic BP reduction after angioplasty as the outcome. Results: In each phase, PG divided by its corresponding prestenotic arterial BP (PG/preBP) had better association with the outcome than PG. The mean phase PG/preBP had the largest area under the curve in the receiver operating characteristic analysis (0.794) with the sensitivity/specificity of 0.957/0.545 for its cut-off >0.15. Although the plasma renin activity, which reflects the perfusion to renal parenchyma, was higher in the angioplasty-efficacious cases than in the angioplasty- inefficacious cases before angioplasty (7.8 ± 6.6 versus 3.4 ± 3.8 ng/ml/h, P = 0.049), it was not generally reduced by angioplasty independent of the outcome. Conclusions: As the index to select ARAS for angioplasty, PG/preBP was better than PG and the mean phase PG/preBP could be the best. However, other factors such as the microvascular kidney disease, which affect the perfusion to renal parenchyma, would influence the outcome.
AB - Background and objectives: Trans-stenotic pressure gradient across the constriction (PG), a hemodynamic variable of atheromatous renal artery stenosis (ARAS), is a widely used indicator for angioplasty, but its association with the outcome of angioplasty has not been fully investigated. Design, setting, participants & measurements: In 34 hypertensive cases with unilateral ARAS, we evaluated hemodymanic variables of ARAS with reference to the systemic BP reduction after angioplasty as the outcome. Results: In each phase, PG divided by its corresponding prestenotic arterial BP (PG/preBP) had better association with the outcome than PG. The mean phase PG/preBP had the largest area under the curve in the receiver operating characteristic analysis (0.794) with the sensitivity/specificity of 0.957/0.545 for its cut-off >0.15. Although the plasma renin activity, which reflects the perfusion to renal parenchyma, was higher in the angioplasty-efficacious cases than in the angioplasty- inefficacious cases before angioplasty (7.8 ± 6.6 versus 3.4 ± 3.8 ng/ml/h, P = 0.049), it was not generally reduced by angioplasty independent of the outcome. Conclusions: As the index to select ARAS for angioplasty, PG/preBP was better than PG and the mean phase PG/preBP could be the best. However, other factors such as the microvascular kidney disease, which affect the perfusion to renal parenchyma, would influence the outcome.
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U2 - 10.2215/CJN.04400808
DO - 10.2215/CJN.04400808
M3 - Article
C2 - 19261820
AN - SCOPUS:66149151023
VL - 4
SP - 651
EP - 655
JO - Clinical journal of the American Society of Nephrology : CJASN
JF - Clinical journal of the American Society of Nephrology : CJASN
SN - 1555-9041
IS - 3
ER -