Suppr超能文献

一项多中心回顾性登记研究中肾动脉支架置入术心脏获益的预测因素

Predictors of cardiac benefits of renal artery stenting from a multicentre retrospective registry.

作者信息

Nakajima Yuri, Kawarada Osami, Higashimori Akihiro, Yokoi Yoshiaki, Zen Kan, Anzai Hitoshi, Doi Hideki, Hokimoto Seiji, Ito Shigenori, Kato Taku, Kume Teruyoshi, Shintani Yoshiaki, Tanimoto Shuzou, Tsubakimoto Yoshinori, Utsunomiya Makoto, Nishimura Kunihiro, Yasuda Satoshi

机构信息

Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.

Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan.

出版信息

Heart Asia. 2017 Sep 14;9(2):e010934. doi: 10.1136/heartasia-2017-010934. eCollection 2017.

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.

摘要

目的

关于动脉粥样硬化性肾动脉疾病(ARAD)患者肾动脉支架置入术后心脏获益预测的数据有限。这项多中心回顾性研究的目的是确定与肾动脉支架置入术后心脏症状改善相关的临床或超声心动图因素。

方法

我们纳入了2000年1月至2015年8月期间在13家医院因心力衰竭、心绞痛或两者而接受初次ARAD成功肾动脉支架置入术的58例患者。

结果

在平均6.0±2.7个月的随访期间,86.2%的患者心脏症状得到改善。与无反应者相比,有反应者的纽约心脏协会功能分级显著更低,估计肾小球滤过率更高,血清肌酐更低,室间隔厚度(IVS)更低,左心室质量指数更低,左心房内径更低,E波速度更低。向后逐步多变量分析确定IVS是心脏症状改善的独立预测因子(比值比0.451,95%置信区间0.209至0.976;p=0.043)。根据受试者工作特征曲线分析,IVS截断值为11.9mm时预测价值最佳,敏感性为71.4%,特异性为75.5%,准确性为73.5%。阳性预测值为74.5%,阴性预测值为72.5%。

结论

这项多中心回顾性研究表明,IVS的超声心动图指数是肾动脉支架置入术后心脏症状改善的独立预测因子。

相似文献

1
Predictors of cardiac benefits of renal artery stenting from a multicentre retrospective registry.
Heart Asia. 2017 Sep 14;9(2):e010934. doi: 10.1136/heartasia-2017-010934. eCollection 2017.
3
Early duplex predicts restenosis after renal artery angioplasty and stenting.
J Vasc Surg. 2012 Nov;56(5):1373-80; discussion 1380. doi: 10.1016/j.jvs.2012.05.067.
4
Predictors of outcome for renal artery stenting performed for salvage of renal function.
J Vasc Surg. 2011 Nov;54(5):1414-1421.e1; discussion 1420-1. doi: 10.1016/j.jvs.2011.04.042. Epub 2011 Jul 31.
9
Baseline inflammatory status and long-term changes in renal function after percutaneous renal artery stenting: a prospective study.
Int J Cardiol. 2013 Aug 10;167(3):1006-11. doi: 10.1016/j.ijcard.2012.03.078. Epub 2012 Apr 13.
10
Ductal Stenting to Retrain the Involuted Left Ventricle in d-Transposition of the Great Arteries.
Ann Thorac Surg. 2019 Sep;108(3):813-819. doi: 10.1016/j.athoracsur.2019.03.045. Epub 2019 Apr 15.

引用本文的文献

1
Renal artery revascularisation: can we predict who benefits?
Heart Asia. 2017 Sep 14;9(2):e010951. doi: 10.1136/heartasia-2017-010951. eCollection 2017.

本文引用的文献

1
Renovascular heart failure: heart failure in patients with atherosclerotic renal artery disease.
Cardiovasc Interv Ther. 2016 Jul;31(3):171-82. doi: 10.1007/s12928-016-0392-2. Epub 2016 Apr 6.
3
SCAI expert consensus statement for renal artery stenting appropriate use.
Catheter Cardiovasc Interv. 2014 Dec 1;84(7):1163-71. doi: 10.1002/ccd.25559. Epub 2014 Aug 19.
4
Prevalence and factors associated with left ventricular remodeling in renal artery stenosis.
J Am Soc Hypertens. 2014 Apr;8(4):254-61. doi: 10.1016/j.jash.2014.01.008. Epub 2014 Jan 27.
5
The "chicken little" of renal stent trials: the CORAL trial in perspective.
JACC Cardiovasc Interv. 2014 Jan;7(1):111-3. doi: 10.1016/j.jcin.2013.12.002.
6
Blood pressure response to renal artery stenting in 901 patients from five prospective multicenter FDA-approved trials.
Catheter Cardiovasc Interv. 2014 Mar 1;83(4):603-9. doi: 10.1002/ccd.25263. Epub 2013 Nov 9.
7
Cardiac function in renovascular hypertensive patients with and without renal dysfunction.
Am J Hypertens. 2014 Mar;27(3):445-53. doi: 10.1093/ajh/hpt203. Epub 2013 Oct 25.
8
Renal artery stenosis in patients with resistant hypertension.
Am J Cardiol. 2013 Nov 1;112(9):1417-20. doi: 10.1016/j.amjcard.2013.06.030.
9
High-risk clinical presentations in atherosclerotic renovascular disease: prognosis and response to renal artery revascularization.
Am J Kidney Dis. 2014 Feb;63(2):186-97. doi: 10.1053/j.ajkd.2013.07.020. Epub 2013 Sep 26.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验