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Predictors of cardiac benefits of renal artery stenting from a multicentre retrospective registry
  1. Yuri Nakajima1,
  2. Osami Kawarada1,2,
  3. Akihiro Higashimori2,
  4. Yoshiaki Yokoi2,
  5. Kan Zen3,
  6. Hitoshi Anzai4,
  7. Hideki Doi5,
  8. Seiji Hokimoto6,
  9. Shigenori Ito7,
  10. Taku Kato8,
  11. Teruyoshi Kume9,
  12. Yoshiaki Shintani10,
  13. Shuzou Tanimoto11,
  14. Yoshinori Tsubakimoto12,
  15. Makoto Utsunomiya13,
  16. Kunihiro Nishimura14,
  17. Satoshi Yasuda1
  1. 1 Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
  2. 2 Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan
  3. 3 Department of Cardiology, Omihachiman Community Medical Center, Shiga, Japan
  4. 4 Department of Cardiology, Ota Memorial Hospital, Gunma, Japan
  5. 5 Department of Cardiology, Kumamoto Rosai Hospital, Kumamoto, Japan
  6. 6 Department of Cardiology, Kumamoto University Hospital, Kumamoto, Japan
  7. 7 Department of Cardiology, Nagoya City East Medical Center, Aichi, Japan
  8. 8 Department of Cardiology, Nantan General Hospital, Kyoto, Japan
  9. 9 Department of Cardiology, Kawasaki Medical School Hospital, Okayama, Japan
  10. 10 Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan
  11. 11 Department of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
  12. 12 Department of Cardiology, Kyoto Second Red Cross Hospital, Kyoto, Japan
  13. 13 Department of Cardiology, Tokyo Rosai Hospital, Tokyo, Japan
  14. 14 Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka, Japan
  1. Correspondence to Dr Osami Kawarada, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan; kawarada90{at}hotmail.com

Abstract

Objectives There have been limited data regarding the prediction of cardiac benefits after renal artery stenting for patients with atherosclerotic renal artery disease (ARAD). The aim of this multicentre retrospective study was to identify clinical or echocardiographic factors associated with improvements of cardiac symptoms after renal artery stenting.

Methods We enrolled 58 patients with de novo ARAD undergoing successful renal artery stenting for heart failure, angina or both between January 2000 and August 2015 at 13 hospitals.

Results Improvement of cardiac symptoms was observed in 86.2% of patients during a mean follow-up of 6.0±2.7 months. Responders demonstrated significantly lower New York Heart Association functional class, higher estimated glomerular filtration rate, lower serum creatinine and lower interventricular septal wall thickness (IVS), lower left ventricular mass index, lower left atrial dimension and lower E-velocity than non-responders. Backward stepwise multivariate analysis identified IVS as an independent predictor of improvement of cardiac symptoms (OR 0.451, 95% CI 0.209 to 0.976; p=0.043). According to receiver operating characteristic curve analysis, an IVS cut-off of 11.9 mm provided the best predictive value, with sensitivity of 71.4%, specificity of 75.5% and accuracy of 73.5%. The positive predictive value was 74.5% and the negative predictive value was 72.5%.

Conclusions This multicentre retrospective study shows that the echocardiographic index of IVS is an independent predictor for improvement of cardiac symptoms after renal artery stenting.

  • Renovascular Disease
  • Renal Stenting
  • Heart Failure
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Footnotes

  • Contributors Each author has contributed significantly to the submitted work. Conception and design or analysis and interpretation of data, or both: YN, OK. Drafting of the manuscript or revising it critically for important intellectual content: YN, OK, SY. Data collection: YN, OK, AH, YY, KZ, HA, HD, SH, SI, TKa, TKu, YS, ST, YT, MU. Sample size determination: KN.

  • Competing interests None declared.

  • Patient consent Not needed because this study is a retrospective observational study.

  • Ethics approval National Cerebral and Cardiovascular Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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