title: Comparison of the renal hyperemic effects of papaverine and dopamine in patients with renal artery stenosis.
abstract: The purpose of this study was to assess the hyperemic effects of papaverine and dopamine in the renal microcirculation of hypertensive patients with renal artery stenosis (RAS). Although a poor correlation between angiographic lesion assessment and its hemodynamic significance is known, angiography is a major criterion for the decision of renal artery stenting. Assessment of the hyperemic translesional pressure gradient was recently shown to be conducive in identifying patients who may benefit from renal revascularization. The study included 14 patients (mean age, 66 ± 11.2 years) with resistant hypertension and moderate RAS. Using a pressure-sensing catheter, systolic, diastolic, and mean translesional pressure gradients, and the distal pressure (Pd):aortic pressure (Pa) ratio (Pd/Pa) were analyzed at baseline and after administration of 40 mg papaverine and 50 μg/kg dopamine. We did not observe significant changes in DG. Dopamine administration resulted in significant changes in systolic and mean translesional pressure gradients and Pd/Pa when compared with baseline (P < .05 for all). Changes in these parameters were caused by a decrease in systolic Pd in comparison with baseline conditions (119 ± 34 mm Hg vs. 101 mm Hg; P < .05). Systolic Pd pressure after papaverine (104 mm Hg) did not change significantly. Systolic and diastolic Pa values did not differ from baseline after either dopamine or papaverine bolus administration.This study indicates that, compared with papaverine, the intrarenal bolus of dopamine in hypertensive patients with RAS remains a more powerful hyperemic agent.
authors.affiliation: Department of Cardiology, Medical University of Wroclaw, Wroclaw, Poland; Research and Development Center, Regional Specialist Hospital, Wroclaw, Poland. Electronic address: mprot@poczta.onet.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Protasiewicz
authors.affiliation: Department of Cardiology, Medical University of Wroclaw, Wroclaw, Poland.
authors.forename: Karol
authors.initials: K
authors.lastname: Początek
authors.affiliation: Department of Internal Diseases and Hypertension, Medical University of Wroclaw, Wroclaw, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Poręba
authors.affiliation: Department of Internal Diseases and Hypertension, Medical University of Wroclaw, Wroclaw, Poland.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Derkacz
authors.affiliation: Department of Internal Diseases and Hypertension, Medical University of Wroclaw, Wroclaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Podgórski
authors.affiliation: Department of Internal Diseases and Hypertension, Medical University of Wroclaw, Wroclaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Gosławska
authors.affiliation: Department of Internal Diseases and Hypertension, Medical University of Wroclaw, Wroclaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Szymańska-Chabowska
authors.affiliation: Department of Internal Diseases and Hypertension, Medical University of Wroclaw, Wroclaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Mazur
authors.affiliation: Department of Cardiology, Medical University of Wroclaw, Wroclaw, Poland; Research and Development Center, Regional Specialist Hospital, Wroclaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Mysiak
authors.affiliation: Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
mesh_terms: D000368:Aged; D004298:Dopamine / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced*; D007668:Kidney / Q000098:blood supply*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D010208:Papaverine / Q000494:pharmacology*; D012039:Regional Blood Flow; D012078:Renal Artery Obstruction / Q000188:drug therapy* / Q000503:physiopathology*; D014665:Vasodilator Agents / Q000494:pharmacology*
chemical_list: D014665:Vasodilator Agents; D010208:Papaverine; D004298:Dopamine
keywords: Kidney; translesional pressure gradient; vasoreactivity