Frequency of severe renal artery stenosis in patients with severe thoracic aortic plaque

The American Journal of Cardiology
Harmony R ReynoldsItzhak Kronzon

Abstract

Atherosclerotic renal artery stenosis (RAS) is an underdiagnosed disorder and a treatable etiology of hypertension and renal insufficiency. All patients were referred for a transesophageal echocardiogram for various indications. Abdominal ultrasound was performed in 69 patients, 43 with severe thoracic aortic plaque (> or =4 mm) and 26 controls with no or mild plaque (< or =2 mm). Severe RAS (> or =60%) was defined as flow velocity > or =1.8 m/s and a renal:aortic ratio of > or =3.5. There were 8 cases of RAS (all severe) in the 43 patients with severe aortic plaque (19% vs 0% of controls; p = 0.02). Severe plaque (p = 0.02) and hypertension (p = 0.03) were correlated with RAS. On multivariate analysis, severe plaque (p = 0.017) and hypertension (p = 0.002) remained independently correlated with RAS. In a paired analysis, matched for age and gender (McNemar), severe plaque was significantly associated with RAS (p = 0.008). Severe thoracic aortic plaque is strongly associated with RAS, which is found in 19% of patients with severe plaque. Patients found to have severe aortic plaque on transesophageal echocardiography should be screened for RAS.

References

Sep 1, 1990·Journal of Vascular Surgery·K J HansenR H Dean
Dec 1, 1994·The New England Journal of Medicine·P AmarencoM G Bousser
Mar 1, 1993·Journal of the American College of Cardiology·A F AppelbeR P Martin

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Citations

Nov 27, 2007·Circulation Journal : Official Journal of the Japanese Circulation Society·Osami KawaradaKazushi Takemoto
Nov 3, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Qi Kong, Xin Ma
Jul 5, 2006·Circulation·Itzhak Kronzon, Paul A Tunick

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