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Regression of left ventricular hypertrophy following stenting of renal artery stenosis

Thomas Zeller1, Aljoscha Rastan, Uwe Schwarzwälder

  • 1Department of Angiology, Herz-Zentrum Bad Krozingen, Germany. thomas.zeller@herzzentrum.de

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|May 10, 2007
PubMed

Insights

Renal artery angioplasty (PTRA) significantly reduces left ventricular hypertrophy (LVH) by decreasing renin-angiotensin-aldosterone system (RAAS) activity. This procedure offers a potential treatment for managing LVH independent of blood pressure changes.

Area of Science:

  • Cardiology
  • Nephrology
  • Hypertension Research

Background:

  • Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular events.
  • Renal artery stenosis (RAS) activates the renin-angiotensin-aldosterone system (RAAS), contributing to hypertension and LVH.
  • Percutaneous transluminal renal angioplasty (PTRA) is a treatment for RAS that may impact RAAS activity.

Purpose of the Study:

  • To investigate whether PTRA, by reducing RAAS activation, can lead to regression of LVH.
  • To assess the effect of PTRA on left ventricular mass index (LVMI) in patients with atherosclerotic renal artery stenosis.

Main Methods:

  • A prospective study involving 102 patients undergoing PTRA for atherosclerotic renal artery stenosis.
  • A control group of 101 patients with essential hypertension was included for comparison.
  • Left ventricular mass index (LVMI) was measured by echocardiography at baseline and during a mean follow-up of 24 months.

Main Results:

  • LVMI significantly decreased by -10 g/m(2) in the PTRA group, while it increased by 9 g/m(2) in the control group (p=0.001).
  • Mean arterial blood pressure significantly reduced in the PTRA group (99 to 90 mmHg) and increased in the control group (102 to 105 mmHg).
  • PTRA was identified as an independent predictor for LVMI regression (p=0.038), irrespective of blood pressure reduction.

Conclusions:

  • PTRA effectively induces regression of LVMI in patients with atherosclerotic renal artery stenosis.
  • The regression of LVMI appears to be independent of the blood pressure-lowering effect of PTRA.
  • Reduced RAAS activity is proposed as the mechanism driving LVMI regression following PTRA.
Abstract

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