|
KMID : 0648320080140020014
|
|
Journal of The Korean Society of Hypertension
2008 Volume.14 No. 2 p.14 ~ p.22
|
|
|
Efficacy of Fractional Flow Reserve of Stenosed Renal artery as a Predictor of the Blood Pressure response after Angioplasty in patients with Renovascular Hypertension
|
|
Cho Yong-Seok
Suh Jung-Won
Lee Sook-Jin
Kim Kwang-Il
Chang Hyuk-Jae
Youn Tae-Jin
Chung Woo-Young
Chae In-Ho
Choi Dong-Ju
Kim Cheol-Ho
|
|
|
Abstract
|
|
|
Background : To evaluate the value of fractional flow reserve(FFR) of stenosed renal artery in predicting the
improvement in blood pressure(BP) after angioplasty in patients with significant renal artery stenosis(RAS) and
hypertension(HT).
Methods : Patients with RAS greater than 50% and HT treated with more than three anti-hypertensive medications were prospectively enrolled (n=34). Before and after renal angioplasty, measurement of FFR was performed. Patients were followed-up at discharge and 1 month. The improvement in BP was defined as a decrease of mean BP greater than 10 mmHg without any change in anti-hypertensive medications or a decrease in number of anti-hypertensive medication greater than 1 without change in mean BP greater than 10 mmHg.
Results : The prevalence of renal artery stenosis was 5.1%(n=103) in 2,009 patients with hypertension and receiving coronary angiography. Among 103 renal artery stenosis patients, 34 patients received percutaneous renal angioplasty (6 patients; bilateral renal angioplasty). Fourteen of 34 patients (41%) showed significant improvement in BP at 1 month. When patients were divided into 2 groups according to the BP improvement at 1 month (Responder vs. Non-responder), the baseline FFR was significantly lower in Responder group than in Non-responder group (0.69 ± 0.26 vs. 0.88 ± 0.12, p=0.039). No other clinical and laboratory variable showed significant difference between 2 groups. However, area under the curve analysis of receiver operating characteristic curve did not show optimal cut-off value of FFR for predicting BP improvement mainly due to the small subject number(AUC of FFR; 0.69, SE 0.11, 95% CI 0.464-0.912, P=0.108).
Conclusions : In patients with significant RAS and HT, 41% showed improvement in BP after angioplasty. The baseline FFR value of stenosed renal artery was significantly lower in patients with BP responders than in BP non-responders suggesting that the baseline FFR value can be a good candidate predictor of further large scale study.
|
|
|
KEYWORD
|
|
|
hypertension, renal artery, blood pressure
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|