Association of renal artery stenosis with aortic jet velocity in hypertensive patients with aortic valve sclerosis.
BACKGROUND
Patients with aortic valve sclerosis (AVS) have an increased risk of cardiovascular events. Patients with atherosclerotic renal artery stenosis (RAS) develop resistant hypertension and heart failure. We hypothesized AVS may be copresent with RAS in hypertensive patients.


METHODS
Hypertensive patients with AVS (n = 167) underwent magnetic resonance (MR) angiography using nonenhanced steady-state free precession (SSFP) technique. More than 75% luminal narrowing in the proximal region of main renal artery was regarded as significant RAS. Peak aortic jet velocity was obtained by Doppler echocardiography. We measured brain natriuretic peptide (BNP), and estimated glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease equation.


RESULTS
Unilateral or bilateral RAS was detected in 40 patients. AVS patients with RAS were older (78 +/- 6 vs. 74 +/- 8 years), and had higher levels of aortic jet velocity (162 +/- 4 vs. 144 +/- 3 cm/s), and lower levels of GFR (55 +/- 13 vs. 62 +/- 14 ml/min/1.73 m(2)) than those without RAS. Higher aortic jet velocity (odds ratio (OR) = 1.58, 95% confidence interval (CI) = 1.09-2.31) and lower GFR (OR = 0.54, 95% CI = 0.33-0.38) were associated with the presence of RAS, after being adjusted for age, systolic blood pressure, and BNP.


CONCLUSIONS
RAS was detected in hypertensive patients with AVS, particularly in patients with higher aortic jet velocity and lower GFR. Higher aortic jet velocity and lower GRF may be useful as a potential indicator for those needing assessment of RAS for risk stratification and deserves further study.
Iida
Masato
M
Department of Cardiology, Mitsubishi Nagoya Hospital, Nagoya, Japan. masato2_iida@mhi.co.jp
Maeda
Hisatosi
H
Yamamoto
Mitsuru
M
Yamazaki
Masatoshi
M
Honjo
Haruo
H
Kodama
Itsuo
I
Kamiya
Kaichiro
K
D000368:Aged; D001021:Aortic Valve / Q000473:pathology*; D050197:Atherosclerosis / Q000150:complications; D004032:Diet; D005260:Female; D005919:Glomerular Filtration Rate; D006334:Heart Function Tests; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D007677:Kidney Function Tests; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D016017:Odds Ratio; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000473:pathology; D012078:Renal Artery Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D012598:Sclerosis; D014463:Ultrasonography
D020097:Natriuretic Peptide, Brain