Cardiovascular complications according to severity of renal artery stenosis based on Doppler ultrasound

IntroductionThe interactions between atherosclerotic renal artery stenosis, independently of severity, and cardiovascular risk, and mortality, are complex and have not been fully researched. The aim of this study was the assessment of the risk of cardiovascular events and mortality in patients with haemodynamically non-significant (NS-RAS) and significant renal artery stenosis (S-RAS) diagnosed with ultrasonography.Material and methodsThe study group consisted of all consecutive patients (n = 2059) who underwent Doppler ultrasound of the renal arteries during a 4-year period. The patients were divided, according to the renal aortic ratio (RAR), into the following groups: S-RAS (RAR ≥ 3.5), NS-RAS (1 < RAR < 3.5), and normal RAR (control group; RAR ≤ 1). The risk of cardiovascular events and death was estimated using Cox’s proportional hazard model, including severity of RAS, age, and gender, based on the data from the National Health Fund on causes of hospitalization, deaths, and statistics on percutaneous coronary angioplasty procedures.ResultsSignificant renal artery stenosis was found in 112 patients (5.4%), NS-RAS in 313 patients (15.2%), and 1634 patients (79.4%) were qualified to the control group. The NS-RAS group had an increased risk of stroke (7.0% vs. 3.0%, HR = 1.77, p = 0.032); S-RAS patients were at increased risk of heart failure (16.1% vs. 5.2%, HR = 2.19, p = 0.002) and death (19.6% vs. 4.3%, HR = 3.08, p < 0.001).ConclusionsThe presence of haemodynamically non-significant renal artery stenosis is an indicator of systemic atherosclerotic changes in vital organs and an important cardiovascular risk factor for stroke.

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Colour Doppler ultrasound in renal artery stenosis: intrarenal waveform analysis

British Journal of Radiology ◽

10.1259/0007-1285-69-825-810 ◽

1996 ◽

Vol 69 (825) ◽

pp. 810-815 ◽

Cited By ~ 45

Author(s):

G M Baxter ◽

F Aitchison ◽

D Sheppard ◽

J G Moss ◽

M J McLeod ◽

...

Keyword(s):

Renal Artery ◽

Renal Artery Stenosis ◽

Doppler Ultrasound ◽

Artery Stenosis ◽

Waveform Analysis ◽

Colour Doppler ◽

Colour Doppler Ultrasound

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Utility of color doppler ultrasound in the evaluation of renal artery stenosis in comparison with contrast-enhanced magnetic resonance angiography

Saudi Journal of Kidney Diseases and Transplantation ◽

10.4103/1319-2442.128518 ◽

2014 ◽

Vol 25 (2) ◽

pp. 309 ◽

Cited By ~ 2

Author(s):

ElnasriM Abuagla ◽

TanSook Pei

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Doppler Ultrasound ◽

Color Doppler ◽

Color Doppler Ultrasound ◽

Artery Stenosis ◽

Contrast Enhanced

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Cardiovascular risk factors in hypertensive patients with coronary artery disease and coexisting renal artery stenosis

Yearbook of Cardiology ◽

10.1016/s0145-4145(08)05019-3 ◽

2008 ◽

Vol 2008 ◽

pp. 93-95

Author(s):

W.J. Elliott

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Cardiovascular Risk ◽

Coronary Artery ◽

Renal Artery ◽

Cardiovascular Risk Factors ◽

Renal Artery Stenosis ◽

Artery Stenosis ◽

Hypertensive Patients ◽

Artery Disease

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Duplex doppler ultrasound in determination of renal artery stenosis

Urologic Radiology ◽

10.1007/bf02926499 ◽

1989 ◽

Vol 11 (1) ◽

pp. 142-147 ◽

Cited By ~ 5

Author(s):

Klaus W. Sievers ◽

Eberhard Löhr ◽

Wolfgang R. Werner

Keyword(s):

Renal Artery ◽

Renal Artery Stenosis ◽

Doppler Ultrasound ◽

Artery Stenosis ◽

Duplex Doppler Ultrasound ◽

Duplex Doppler

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to determine diagnostic efficiency of vascular color Doppler ultrasound for renal artery stenosis

International Journal of Radiology and Diagnostic Imaging ◽

10.33545/26644436.2019.v2.i1a.20 ◽

2019 ◽

Vol 2 (1) ◽

pp. 10-12

Author(s):

Dr. Hitesh Yadav

Keyword(s):

Renal Artery ◽

Renal Artery Stenosis ◽

Doppler Ultrasound ◽

Color Doppler ◽

Color Doppler Ultrasound ◽

Artery Stenosis ◽

Diagnostic Efficiency

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Underlying cardiovascular risk and major adverse cardiovascular events after acute respiratory infection: a population-based cohort study of over 4.2 million individuals in England, 2008-2018

10.1101/2021.03.18.21253890 ◽

2021 ◽

Author(s):

Jennifer Davidson ◽

Amitava Banerjee ◽

Liam Smeeth ◽

Helen I McDonald ◽

Daniel J Grint ◽

...

Keyword(s):

Cohort Study ◽

Cardiovascular Risk ◽

Cardiovascular Events ◽

Respiratory Infections ◽

Cardiovascular Complications ◽

Major Adverse Cardiovascular Events ◽

Mortality Data ◽

Clinical Practice Research Datalink ◽

Increased Risk ◽

One Year

Background While acute respiratory infections (ARIs) can lead to cardiovascular complications, the effect of underlying cardiovascular risk profile on ARI incidence and cardiovascular complications in those without established cardiovascular disease (CVD) is unknown. Whether to consider individuals at raised cardiovascular risk a priority group for vaccination against respiratory infections therefore remains unclear. Methods We conducted a cohort study in individuals aged 40-64 years without established CVD or a chronic health condition eligible for influenza vaccination, using Clinical Practice Research Datalink GOLD and Aurum data from 01/09/2008-31/08/2018 linked to Hospital Episode Statistics Admitted Patient Care and Office for National Statistics mortality data from England. We classified cardiovascular risk based on diagnosed hypertension and overall predicted cardiovascular risk estimated using QRISK2 score (≥10% compared with <10%). Using multivariable Poisson regression models, we obtained incidence rate ratios (IRR) for ARI. Among individuals who had an ARI, we then used multivariable Cox regression to obtain hazard ratios (HR) for the risk of major adverse cardiovascular events (MACE) within one year of infection. Findings 4,212,930 individuals were included; 12.5% had hypertension and 14.4% had a QRISK2 score ≥10%. After adjusting for confounders, patients with hypertension (IRR 1.04, 95% CI 1.03-1.05) or QRISK2 score ≥10% (IRR 1.39, 1.37-1.40) had a higher incidence of ARI. Of the 442,408 individuals with an ARI, 4,196 had a MACE within one year of infection. After adjustment, hypertension (HR 1.98, 1.83-2.15) and QRISK2 score ≥10% (HR 3.65, 3.42-3.89) were associated with substantial increased risk of a MACE after infection. Interpretation People without diagnosed CVD but who have raised cardiovascular risk, measured by diagnosed hypertension or, in particular, overall predicted cardiovascular risk, have increased incidence of both ARI and cardiovascular complications following an ARI.

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Value of Doppler ultrasound for the diagnosis of renal artery stenosis in children

Pediatric Nephrology ◽

10.1007/s004670050227 ◽

1997 ◽

Vol 11 (1) ◽

pp. 27-30 ◽

Cited By ~ 50

Author(s):

Philippe Brun ◽

Heykel Kchouk ◽

Brigitte Mouchet ◽

Véronique Baudouin ◽

Alain Raynaud ◽

...

Keyword(s):

Renal Artery ◽

Renal Artery Stenosis ◽

Doppler Ultrasound ◽

Artery Stenosis

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Contrast-enhanced Doppler ultrasound for renal artery stenosis

Australasian Radiology ◽

10.1046/j.1440-1673.1999.00635.x ◽

1999 ◽

Vol 43 (2) ◽

pp. 206-209 ◽

Cited By ~ 5

Author(s):

Rj Dowling Mk House Pm King Jl Bourke ◽

RN Gibson

Keyword(s):

Renal Artery ◽

Renal Artery Stenosis ◽

Doppler Ultrasound ◽

Artery Stenosis ◽

Contrast Enhanced

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Fluid volumes and pressor responsiveness in two-kidney rabbits with renal artery stenosis

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1982.243.5.h779 ◽

1982 ◽

Vol 243 (5) ◽

pp. H779-H787 ◽

Cited By ~ 1

Author(s):

J. A. Johnson ◽

K. D. Kurz ◽

S. Siripaisarnpipat ◽

D. W. Zeigler ◽

C. G. Payne

Keyword(s):

Mean Arterial Pressure ◽

Arterial Pressure ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Body Fluid ◽

Cardiovascular Responses ◽

Artery Stenosis ◽

Control Group ◽

Ang Ii ◽

Pressor Responses

This study examined body fluid volumes, the pressor responses to norepinephrine (NE), and the cardiovascular responses to NE before and during infusion of an angiotensin II (ANG II) antagonist in two-kidney rabbits with unilateral renal artery stenosis (RAS) of 3 and 30 day duration. Three separate experiments were performed. In the first experiment, plasma volume, extracellular fluid volume, and total body water were measured by the distribution volumes of radioiodinated serum albumin, 35SO4, and tritiated water, respectively. No differences were seen for any of these volumes between the 3- or 30-day RAS rabbits and their controls. In the second experiment, pressor responses to infusions of several doses of NE were examined; rabbits with 3- and 30-day RAS had exaggerated pressor responses to all doses of NE when compared with the control rabbits. In the third experiment, infusion of NE at 800 ng.min-1.kg body wt-1 resulted in more pronounced increases in mean arterial pressure and total peripheral resistance (TPR) in the 3- and 30-day RAS rabbits than in the controls; after infusion of [Sar1-Ile8] ANG II the increases in mean arterial pressure and TPR during NE infusion were blunted and were of the same magnitude as in the control group. In all experiments the 30-day RAS rabbits were hypertensive, whereas the 3-day RAS rabbits were normotensive; also, plasma renin activity (PRA) values were normal in both the 3- and 30-day RAS groups. These studies demonstrated that increases in body fluid volumes are not necessary for pressor and vascular hyperresponsiveness probably is mediated by ANG II, despite normal PRA values.

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