Related Experiment Video
Updated: May 26, 2026
A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
Published on: October 26, 2020
The heart in atherosclerotic renovascular disease
1Salford Royal Hospital, Stott Lane, M6 8HD, UK.
Insights
Atherosclerotic renovascular disease (ARVD) significantly increases cardiovascular risks and mortality. While revascularization shows no broad benefit, identifying specific patient subgroups for this intervention is crucial for improved cardiac outcomes.
Area of Science:
- Cardiology
- Nephrology
- Vascular Medicine
Background:
- Atherosclerotic renovascular disease (ARVD) is linked to elevated cardiovascular disease (CVD) and mortality.
- ARVD is a primary cause of secondary hypertension and prevalent in elderly heart failure patients.
- Most ARVD patients (95%) exhibit cardiac abnormalities, notably left ventricular hypertrophy (LVH) and diastolic dysfunction, potentially due to renin-angiotensin system overactivity.
Purpose of the Study:
- To review the impact of atherosclerotic renovascular disease on cardiovascular health.
- To evaluate the current evidence on renal artery revascularization versus medical therapy for ARVD.
- To identify potential strategies for optimizing ARVD patient management.
Main Methods:
- Literature review of randomized trials and case series concerning ARVD.
- Analysis of the association between ARVD, cardiovascular events, and cardiac structure/function.
- Examination of the role of the renin-angiotensin pathway in ARVD-related cardiac changes.
Main Results:
- Randomized trials indicate no cardiovascular event reduction with renal artery revascularization compared to medical therapy.
- Small case series suggest potential cardiac benefits of revascularization in specific ARVD cases.
- A strong correlation exists between ARVD presence and CVD severity, with significant cardiac abnormalities in most patients.
Conclusions:
- Current evidence does not support routine renal artery revascularization for all ARVD patients.
- Further research is needed to identify ARVD subgroups who may benefit from revascularization.
- Targeted therapeutic strategies focusing on specific patient profiles are essential for improving outcomes in ARVD.
Abstract:
Atherosclerotic renovascular disease (ARVD) is associated with a high rate of cardiovascular disease and mortality. ARVD is an independent risk factor for adverse outcome in coronary artery disease and there is a correlation between the presence of ARVD and severity of cardiovascular disease. ARVD is the most common cause of secondary hypertension and can be found in up to half of elderly patients with chronic heart failure. Abnormal cardiac structure and / or function will be present in 95 % of ARVD patients, with left ventricular hypertrophy (LVH) and diastolic dysfunction the predominant abnormalities. These are likely to be due in part to over-activity of the renin-angiotensin pathway. Up to now, randomised trials have shown no benefit of renal artery revascularisation over medical therapy in terms of cardiovascular events but small case series clearly demonstrate situations where cardiac structure and function respond to revascularisation. Future strategies must focus on accurately identifying sub-groups of ARVD patients for whom revascularisation should be first line therapy.
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