Department of Ultrasound Medicine, Peking University First Hospital, Beijing, China.
Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China.
Technol Health Care. 2024;32(2):963-976. doi: 10.3233/THC-230357.
Atherosclerotic renal artery stenosis (ARAS) is a common disease in the elderly population.
The aim was to develop a contrast-enhanced ultrasound (CEUS)-based model for predicting post-angioplasty improvement in hypertension in patients with severe ARAS.
Thirty-five patients with severe ARAS (⩾ 70%) were included in this study, and 42 renal arteries received percutaneous transluminal renal arterial stenting. An optimal integral formula was developed from pre-interventional color-coded duplex sonography (CCDS) and CEUS parameters using least absolute shrinkage and selection operator (LASSO) regression and receiver operating characteristic (ROC) curve analysis. A model for predicting short-term hypertension improvement was established using the integral formula and clinical risk factors. Bootstrapping was used for internal validation.
Two integral formulas, LASSO.CCDS and LASSO.CEUS, were established. ROC curves of the two integral formulas showed that LASSO.CEUS was the better formula for predicting hypertension improvement (AUC 0.816, specificity 78.6%). Univariate and multivariate regression analyses showed that duration of hypertension (OR 0.841, P= 0.027), diabetes (OR = 0.019, P= 0.010), and LASSO.CEUS (OR 7.641, P= 0.052) were predictors of short-term hypertension improvement after interventional therapy. Using LASSO.CEUS combined with clinical risk factors, the following prediction model was established: logit (short-term improvement in hypertension) = 1.879-0.173 × hypertension duration - 3.961 × diabetes + 2.034 × LASSO.CEUS (AUC 0.939).
The model established using CEUS parameters and clinical risk factors could predict hypertension improvement after interventional therapy, but further research and verification are needed.
动脉粥样硬化性肾动脉狭窄（ARAS）是老年人群中的一种常见疾病。
旨在开发一种基于对比增强超声（CEUS）的模型，用于预测严重 ARAS 患者血管成形术后高血压的改善情况。
本研究纳入 35 例严重 ARAS（≥70%）患者，42 条肾动脉接受经皮腔内肾动脉血管成形术。使用最小绝对收缩和选择算子（LASSO）回归和接收者操作特征（ROC）曲线分析，从术前彩色编码双功超声（CCDS）和 CEUS 参数中开发出最佳积分公式。使用积分公式和临床危险因素建立预测短期高血压改善的模型。使用 bootstrap 进行内部验证。
建立了两个积分公式，LASSO.CCDS 和 LASSO.CEUS。两个积分公式的 ROC 曲线表明，LASSO.CEUS 是预测高血压改善的更好公式（AUC 0.816，特异性 78.6%）。单因素和多因素回归分析表明，高血压持续时间（OR 0.841，P=0.027）、糖尿病（OR=0.019，P=0.010）和 LASSO.CEUS（OR 7.641，P=0.052）是介入治疗后短期高血压改善的预测因素。使用 LASSO.CEUS 结合临床危险因素，建立了以下预测模型：logit（高血压短期改善）=1.879-0.173×高血压持续时间-3.961×糖尿病+2.034×LASSO.CEUS（AUC 0.939）。
使用 CEUS 参数和临床危险因素建立的模型可以预测介入治疗后高血压的改善情况，但需要进一步的研究和验证。
