Geraci Giulio, Buccheri Dario, Zanoli Luca, Fatuzzo Pasquale, Di Natale Katia, Zammuto Marta M, Nardi Emilio, Geraci Calogero, Mancia Ettore, Zambelli Giulia, Piraino Davide, Signorelli Salvatore S, Granata Antonio, Cottone Santina, Mule Giuseppe
Unit of Nephrology and Hypertension-European Society of Hypertension Excellence Centre, Paolo Giaccone University Hospital, I-90127 Palermo, Italy.
Unit of Interventional Cardiology, Hospital San Giovanni di Dio, I-92100 Agrigento, Italy.
Exp Ther Med. 2019 Apr;17(4):3255-3263. doi: 10.3892/etm.2019.7279. Epub 2019 Feb 15.
Intrarenal hemodynamic alterations are independent predictors of cardiovascular events in different populations. It has been hypothesized that there is an association between renal hemodynamics and coronary atherosclerotic burden in patients with hypertension. Therefore, the present study examined the associations between renal hemodynamics, coronary atherosclerotic burden and carotid atherosclerotic disease. A total of 130 patients with hypertension aged between 30-80 years who had been referred for an elective coronary angiography were enrolled in the present study. A duplex ultrasound of the intrarenal vasculature was performed to evaluate the resistive index (RI), pulsatility index (PI) and acceleration time (AT). The carotid intima-media thickness was additionally assessed. A coronary angiography was performed to detect the atherosclerotic burden using the Gensini Score (GS). Based on the GS values, subjects were divided into quintiles (I: ≤9; II: 9-17; III: 17-30; IV: 30-44; and V: GS >44) as well as in subjects with mild (GS ≤30) or severe coronary disease (GS >30). A weak significant difference in PI was identified among quintiles (P=0.041), whereas, RI and AT did not differ significantly. PI was associated with GS in the group with low coronary atherosclerotic burden (GS ≤30; P=0.047), whereas, no association was detected in subjects with GS >30. This association remained following adjustment for age and left ventricular ejection fraction (P=0.025). In conclusion, renal vascular alterations were associated with coronary atherosclerotic burden in patients with hypertension with mild coronary disease.
肾内血流动力学改变是不同人群心血管事件的独立预测因素。据推测，高血压患者的肾血流动力学与冠状动脉粥样硬化负荷之间存在关联。因此，本研究探讨了肾血流动力学、冠状动脉粥样硬化负荷和颈动脉粥样硬化疾病之间的关联。本研究共纳入了130例年龄在30 - 80岁之间因择期冠状动脉造影而转诊的高血压患者。对肾内血管系统进行双功超声检查，以评估阻力指数（RI）、搏动指数（PI）和加速时间（AT）。另外评估颈动脉内膜中层厚度。进行冠状动脉造影，使用Gensini评分（GS）检测动脉粥样硬化负荷。根据GS值，将受试者分为五分位数组（I：≤9；II：9 - 17；III：17 - 30；IV：30 - 44；V：GS >44）以及轻度（GS≤30）或重度冠状动脉疾病（GS >30）的受试者。在五分位数组中PI存在微弱的显著差异（P = 0.041），而RI和AT无显著差异。在冠状动脉粥样硬化负荷较低的组（GS≤30；P = 0.047）中，PI与GS相关，而在GS >30的受试者中未检测到关联。在调整年龄和左心室射血分数后，这种关联仍然存在（P = 0.025）。总之，肾血管改变与轻度冠状动脉疾病的高血压患者的冠状动脉粥样硬化负荷相关。
