title: Effect of acute intravenous ace-inhibition on the intrarenal doppler flow characteristics in hypertensive patients with and without unilateral renal artery stenosis.
abstract: Assessment of intrarenal doppler signals is of particular importance in screening for renal artery stenosis. We studied the effect of acute ACE-inhibition (1,25 mg enalaprilate i.v.) on intrarenal resistive indices in 10 hypertensive patients with unilateral renal artery stenosis versus 10 patients with essential hypertension. Any changes limited to poststenotic vessels could possibly improve the diagnostic value of duplex sonography. After ACE-inhibition a significant fall of the intrarenal Resistive Index occurred in both patient groups. In cases of unilateral renal artery stenosis we saw a tendency to an increased side difference of the Resistive Index due to a greater fall on the poststenotic side. Therefore a clear advantage of duplex scanning after acute ACE-inhibition due to a limited effect of enalaprilate on poststenotic vessels was not found. The results suggest that the vascular resistance and not only the degree of renal artery stenosis is of significance for the characteristics of the doppler signal.
authors.affiliation: Department of Nephrology and Rheumatology, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: G R
authors.initials: GR
authors.lastname: Hetzel
authors.forename: M
authors.initials: M
authors.lastname: Hollenbeck
authors.forename: A
authors.initials: A
authors.lastname: Voiculescu
authors.forename: J
authors.initials: J
authors.lastname: Malms
authors.forename: M
authors.initials: M
authors.lastname: Cohnen
authors.forename: R
authors.initials: R
authors.lastname: Willers
authors.forename: U
authors.initials: U
authors.lastname: Mödder
authors.forename: B
authors.initials: B
authors.lastname: Grabensee
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D015773:Enalaprilat / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012079:Renal Circulation / Q000187:drug effects*; D018616:Ultrasonography, Doppler, Duplex; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D015773:Enalaprilat