title: Regression of left ventricular hypertrophy following stenting of renal artery stenosis.
abstract: OBJECTIVE
  To determine if angioplasty of atherosclerotic renal artery stenosis, which reduces the activation of the renin-angiotensin-aldosterone system (RAAS), may lead to regression of left ventricular hypertrophy.
  
  
  METHODS
  The study included 102 patients (58 men; mean age 67 years, range 66-69) who underwent stent-supported percutaneous transluminal renal angioplasty (PTRA) and were included in a clinical follow-up program (mean 24+/-14 months, range 6-60). As a control group, 101 contemporaneous patients (68 men; mean age 68 years, range 66-70) with essential hypertension were investigated. The primary endpoint was the change in left ventricular mass index (LVMI) determined by echocardiography.
  
  
  RESULTS
  Mean follow-up intervals were 24+/-14 months (range 6-60) in the study group and 27+/-14 months (range 6-60) in the controls (p = 0.09). LVMI decreased significantly by -10+/-26 g/m(2) in the study group, while it increased significantly by 9+/-28 g/m(2) in the control group (p = 0.001 between groups). In the study group, mean arterial blood pressure was significantly reduced from 99+/-11 mmHg to 90+/-11 mmHg (p<0.0001) during follow-up despite a significant reduction in medication, whereas it increased significantly from 102+/-11 mmHg to 105+/-11 mmHg (p = 0.008) in the control group, although medication was significantly increased. After adjustment for various factors and covariables, PTRA prevailed as an independent predictor for regression of LVMI (p = 0.038).
  
  
  CONCLUSIONS
  PTRA induces regression of LVMI that is independent of the reduction in blood pressure induced by this procedure. Reduced activity of the RAAS may account for this regression.
authors.affiliation: Department of Angiology, Herz-Zentrum Bad Krozingen, Germany. thomas.zeller@herzzentrum.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Zeller
authors.forename: Aljoscha
authors.initials: A
authors.lastname: Rastan
authors.forename: Uwe
authors.initials: U
authors.lastname: Schwarzwälder
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.forename: Ulrich
authors.initials: U
authors.lastname: Frank
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Bürgelin
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sixt
authors.forename: Thomas
authors.initials: T
authors.lastname: Schwarz
authors.forename: Elias
authors.initials: E
authors.lastname: Noory
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D050197:Atherosclerosis / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D011379:Prognosis; D012078:Renal Artery Obstruction / Q000150:complications / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012084:Renin-Angiotensin System; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography