Doppler flow wire evaluation of renal blood flow reserve in hypertensive patients with normal renal arteries.
OBJECTIVE
To study the vasomotor responses of the renal microcirculation in patients with essential hypertension.


METHODS
We studied the reactivity of the renal microcirculation to papaverine, with intraarterial Doppler and quantitative arteriography, in 34 renal arteries of 19 hypertensive patients without significant renal artery stenosis. Isosorbide dinitrate was given to maximally dilate proximal renal arteries. APV (average peak blood flow velocity) was used as an index of renal blood flow.


RESULTS
Kidneys could be divided into two distinct subgroups based on their response to papaverine. An increase in APV of up to 55% occurred in 21 kidneys, an increase > 55% in 13 kidneys. Within each group the values were normally distributed. Both baseline APV and the effect of papaverine on mean velocity differed significantly between groups.


CONCLUSIONS
There seems to be a subgroup of patients with essential hypertension that has an impaired reactivity to papaverine, consistent with a functional impairment of the renal microcirculation. Further studies are required to determine whether this abnormality contributes to or results from elevated blood pressure.
Beregi
J P
JP
Department of Vascular Radiology, Hôpital Cardiologique, CHRU de Lille, F-59037 Lille, France. jpberegi@chru-lille.fr
Mounier-Vehier
C
C
Devos
P
P
Gautier
C
C
Libersa
C
C
McFadden
E P
EP
Carré
A
A
D000704:Analysis of Variance; D000792:Angiography; D001783:Blood Flow Velocity / Q000187:drug effects; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000503:physiopathology*; D007548:Isosorbide Dinitrate / Q000494:pharmacology*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010208:Papaverine / Q000494:pharmacology*; D015641:Radiography, Interventional; D012079:Renal Circulation / Q000187:drug effects*; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016284:Technetium Tc 99m Pentetate; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D014665:Vasodilator Agents / Q000494:pharmacology*
D003287:Contrast Media; D014665:Vasodilator Agents; D010208:Papaverine; D007548:Isosorbide Dinitrate; D016284:Technetium Tc 99m Pentetate