title: Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease.
abstract: Percutaneous transluminal renal artery stenting (PTRAS) has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis (ARAS). Whether PTRAS could improve left ventricular hypertrophy (LVH) and reduce adverse events when based on percutaneous coronary intervention (PCI) for patients with coronary artery disease (CAD) and ARAS is still unclear. A retrospective study was conducted, which explored the effect of concomitant PCI and PTRAS versus PCI alone for patients with CAD and ARAS complicated by heart failure with preserved ejection fraction (HFpEF). A total of 228 patients meeting inclusion criteria were divided into two groups: (1) the HFpEF-I group, with PCI and PTRAS; (2) the HFpEF-II group, with PCI alone. Both groups had a two-year follow-up. The left ventricular mass index (LVMI) and other clinical characteristics were compared between groups. During the follow-up period, a substantial decrease in systolic blood pressure (SBP) was observed in the HFpEF-I group, but not in the HFpEF-II group. There was marked decrease in LVMI in both groups, but the HFpEF-I group showed a greater decrease than the HFpEF-II group. Regression analysis demonstrated that PTRAS was significantly associated with LVMI reduction and fewer adverse events after adjusting for other factors. In HFpEF patients with both CAD and ARAS, concomitant PCI and PTRAS can improve LVH and decrease the incidence of adverse events more than PCI alone. This study highlights the beneficial effect of ARAS revascularization, as a new and more aggressive revascularization strategy for such high-risk patients.
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510080, China.
authors.forename: Hao-jian
authors.initials: HJ
authors.lastname: Dong
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510080, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510080, China.
authors.forename: De-mou
authors.initials: DM
authors.lastname: Luo
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510080, China.
authors.forename: Jing-guang
authors.initials: JG
authors.lastname: Ye
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510080, China.
authors.forename: Jun-qing
authors.initials: JQ
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510080, China.
authors.forename: Guang
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510080, China.
authors.forename: Jian-fang
authors.initials: JF
authors.lastname: Luo
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510080, China.
authors.forename: Ying-ling
authors.initials: YL
authors.lastname: Zhou
mesh_terms: D000368:Aged; D059347:Cardio-Renal Syndrome / Q000175:diagnosis / Q000601:surgery; D003131:Combined Modality Therapy / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012077:Renal Artery / Q000601:surgery; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Coronary artery disease (CAD); Heart failure with preserved ejection fraction (HFpEF); Percutaneous transluminal renal artery stenting (PTRAS); Renal artery stenosis