ID 109759
Title Transcription
シンフゼン オ ガッペイ シタ ジンケッカンセイ コウケツアツ ニ タイスル ケイヒテキ ジンドウミャク ケイセイジュツ ノ ユウコウセイ
Title Alternative
Efficacy of percutaneous transluminal renal angioplasty for renovascular hypertension complicated with heart failure
Author
Imada, Kumiko Junior resident, Tokushima University Hospital
Ota, Rie Division of Cardiology, Tokushima University Hospital
Kadota, Muneyuki Division of Cardiology, Tokushima University Hospital
Takashima, Akira Division of Cardiology, Tokushima University Hospital
Iwase, Takashi Division of Cardiology, Tokushima University Hospital KAKEN Search Researchers
Keywords
heart failure
cardiac disturbance syndrome
percutaneous transluminal renal angioplasty
Content Type
Journal Article
Description
【Background】
Percutaneous transluminal renal angioplasty (PTRA) is recommended for patients with heart failure due to renovascular hypertension ; however, the clinical characteristics of the patients and the effects of PTRA on heart failure and cardiorenal function have not been elucidated.
【Methods】
We retrospectively analyzed data for 4 PTRA-treated patients (male/female, 1/3 ; mean age, 70.0±10 years ; mean left ventricular ejection fraction, 51.5±15.2%) with heart failure due to renovascular hypertension and evaluated the effects of PTRA on heart failure and cardiorenal function 6 months after treatment.
【Results】
All patients had pro-arteriosclerotic diseases including diabetes mellitus, essential thrombocythemia, heparin cofactor II deficency, metabolic syndrome, and familial hypercholesterolemia, and 3 patients had ischemic heart disease. No abdominal bruit was heard and mean plasma renin activity was 4.5±3.6 ng/ml/hr, which was not elevated, contrary to expectation. All contralateral kidneys of PTRA were nonfunctioning, suggesting bilateral kidneys were disturbed in all patients.
In all patients, PTRA was successfully performed and resolved heart failure. PTRA resulted in decreases in systolic blood pressure from 157±18 to 124±8.6 mmHg, mean serum creatinine from 3.2±2.6 to 2.7±2.2 mg/dl, and mean BNP from 919±998 to 243±291 pg/ml at 6 months after treatment. PTRA did not change left ventricular ejection fraction, a parameter of systolic fraction evaluated by an echocardiogram ; however, PTRA improved E/e’, a parameter of left ventricular diastolic fraction, from 16.1±5.2 to 9.7±3.7. None of the patients were hospitalized due to heart failure during the 6-month period after PTRA.
【Conclusions】
Patients with heart failure with cardiovascular risk factors should be screened for renovascular hypertension regardless of abdominal bruit or plasma renin activity. PTRA is effective for resolving heart failure and for improving renal and cardiac diastolic functions in patients with renovascular hypertension complicated with heart failure.
Journal Title
四国医学雑誌
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
70
Issue
3-4
Start Page
87
End Page
92
Sort Key
87
Published Date
2014-08-25
Remark
P.91著者英語表記 : Soegi(ソエギ)は、Soeki(ソエキ)が正しいと思われる。
EDB ID
FullText File
language
jpn
TextVersion
Publisher
departments
Medical Sciences
University Hospital