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.
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.
Authors: William R Colyer; Christopher J Cooper; Mark W Burket; William J Thomas Journal: Catheter Cardiovasc Interv Date: 2003-07 Impact factor: 2.692
Authors: John H Rundback; David Sacks; K Craig Kent; Christopher Cooper; Daniel Jones; Timothy Murphy; Kenneth Rosenfield; Christopher White; Michael Bettmann; Stanley Cortell; Jules Puschett; Dan Clair; Patricia Cole Journal: Circulation Date: 2002-09-17 Impact factor: 29.690
Authors: J Radermacher; A Chavan; J Bleck; A Vitzthum; B Stoess; M J Gebel; M Galanski; K M Koch; H Haller Journal: N Engl J Med Date: 2001-02-08 Impact factor: 91.245
Authors: George S Stergiou; Stamatis P Efstathiou; Christina V Alamara; Stilianos E Mastorantonakis; Leonidas G Roussias Journal: J Hypertens Date: 2003-12 Impact factor: 4.844