title: Frequency of severe renal artery stenosis in patients with severe thoracic aortic plaque.
abstract: Atherosclerotic renal artery stenosis (RAS) is an underdiagnosed disorder and a treatable etiology of hypertension and renal insufficiency. All patients were referred for a transesophageal echocardiogram for various indications. Abdominal ultrasound was performed in 69 patients, 43 with severe thoracic aortic plaque (> or =4 mm) and 26 controls with no or mild plaque (< or =2 mm). Severe RAS (> or =60%) was defined as flow velocity > or =1.8 m/s and a renal:aortic ratio of > or =3.5. There were 8 cases of RAS (all severe) in the 43 patients with severe aortic plaque (19% vs 0% of controls; p = 0.02). Severe plaque (p = 0.02) and hypertension (p = 0.03) were correlated with RAS. On multivariate analysis, severe plaque (p = 0.017) and hypertension (p = 0.002) remained independently correlated with RAS. In a paired analysis, matched for age and gender (McNemar), severe plaque was significantly associated with RAS (p = 0.008). Severe thoracic aortic plaque is strongly associated with RAS, which is found in 19% of patients with severe plaque. Patients found to have severe aortic plaque on transesophageal echocardiography should be screened for RAS.
authors.affiliation: Noninvasive Cardiology Laboratory, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA.
authors.forename: Harmony R
authors.initials: HR
authors.lastname: Reynolds
authors.forename: Paul A
authors.initials: PA
authors.lastname: Tunick
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Benenstein
authors.forename: Navin C
authors.initials: NC
authors.lastname: Nakra
authors.forename: Alan
authors.initials: A
authors.lastname: Shah
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Spevack
authors.forename: Itzhak
authors.initials: I
authors.lastname: Kronzon
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D001161:Arteriosclerosis / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000453:epidemiology