Correlation of renal cortical blood perfusion and BP response after renal artery stenting
BackgroundThis study aimed to observe the correlation between renal cortical blood perfusion (CBP) parameters and BP response in patients with severe renal artery stenosis (RAS) who underwent stenting.MethodsThis was a single-center retrospective cohort study. A total of 164 patients with unilateral...
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| Format: | Article |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.939519/full |
| _version_ | 1811205103591358464 |
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| author | Siyu Wang Siyu Wang Sijie Zhang Sijie Zhang Sijie Zhang Yan Li Yan Li Na Ma Na Ma Mengpu Li Mengpu Li Hu Ai Hu Ai Hui Zhu Hui Zhu Junhong Ren Junhong Ren Yongjun Li Yongjun Li Peng Li |
| author_facet | Siyu Wang Siyu Wang Sijie Zhang Sijie Zhang Sijie Zhang Yan Li Yan Li Na Ma Na Ma Mengpu Li Mengpu Li Hu Ai Hu Ai Hui Zhu Hui Zhu Junhong Ren Junhong Ren Yongjun Li Yongjun Li Peng Li |
| author_sort | Siyu Wang |
| collection | DOAJ |
| description | BackgroundThis study aimed to observe the correlation between renal cortical blood perfusion (CBP) parameters and BP response in patients with severe renal artery stenosis (RAS) who underwent stenting.MethodsThis was a single-center retrospective cohort study. A total of 164 patients with unilateral severe RAS after successful percutaneous transluminal renal artery stenting in Beijing Hospital from October 2017 to December 2020 were included. According to the results of BP evaluated at 12 months, all patients were divided into the BP response group (n = 98) and BP nonresponse group (n = 66). The baseline clinical and imaging characteristics and follow-up data about 24 h ABPM and CBP were recorded and analyzed. Pearson correlation analysis was used to evaluate the relationship between CBP parameters and 24 h average SBP. Univariate and multivariate logistic regression analysis was used to evaluate the risk factors for BP response.ResultsAmong 164 patients with severe RAS, there were 100 males (61.0%), aged 37–75 years, with an average of 56.8 ± 18.4 years, and average artery stenosis of 84.0 ± 12.5%. The BP nonresponse patients had a longer duration of hypertension, more current smoking subjects and diabetic patients, lower eGFR, increased number of hypertensive agents, and rate of insulin compared with the BP response group (P < 0.05). After PTRAS, patients in the BP response group were associated with significantly lower BP and improved CPB, characterized by increased levels of maximum intensity (IMAX), area under ascending curve (AUC1), area under the descending curve (AUC2), shortened rising time (RT), mean transit time (mTT), and prolonged time to peak intensity (TTP; P < 0.05). However, the BP nonresponse group was only associated with significantly reduced RT (P < 0.05) compared with baseline data. During an average follow-up of 11.5 ± 1.7 months, the BP response group was associated with significantly lower levels of SBP, DBP, 24 h average SBP, and 24 h average DBP compared with the nonresponse group (P < 0.05). Pearson correlation analysis showed that the the pre-operative CBP parameters, including IMAX (r = 0.317), RT (r = 0.249), AUC1 (r = 0.614), AUC2 (r = 0.558), and postoperative CBP parameters, including RT (r = 0.283), AUC1 (r = 0.659), and AUC2 (r = 0.674) were significantly positively correlated with the 24 h average SBP, while the postoperative TTP (r = −0.413) and mTT (r = −0.472) were negatively correlated with 24 h average SBP (P < 0.05). Multivariate Logistic regression analysis found that diabetes (OR = 1.294), NT-proBNP (OR = 1.395), number of antihypertensive agents (OR = 2.135), pre-operation IMAX (OR = 1.534), post-operation AUC2 (OR = 2.417), and baseline dDBP (OR = 2.038) were related factors for BP response (all P < 0.05).ConclusionPatients in the BP nonresponse group often have diabetes, a longer duration of hypertension, significantly reduced glomerular filtration rate, and heavier renal artery stenosis. CBP parameters are closely related to 24 h average SBP, and pre-operation IMAX and post-operation AUC2 are markers for a positive BP response. |
| first_indexed | 2024-04-12T03:24:55Z |
| format | Article |
| id | doaj.art-3b6ed00f245f4b43a49163aa14b7b680 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T03:24:55Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-3b6ed00f245f4b43a49163aa14b7b6802022-12-22T03:49:45ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-10-01910.3389/fcvm.2022.939519939519Correlation of renal cortical blood perfusion and BP response after renal artery stentingSiyu Wang0Siyu Wang1Sijie Zhang2Sijie Zhang3Sijie Zhang4Yan Li5Yan Li6Na Ma7Na Ma8Mengpu Li9Mengpu Li10Hu Ai11Hu Ai12Hui Zhu13Hui Zhu14Junhong Ren15Junhong Ren16Yongjun Li17Yongjun Li18Peng Li19Department of Sonography, Beijing Hospital, National Center of Gerontology, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Sonography, Beijing Hospital, National Center of Gerontology, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaGraduate School of Peking Union Medical College, Beijing, ChinaDepartment of Sonography, Beijing Hospital, National Center of Gerontology, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Sonography, Beijing Hospital, National Center of Gerontology, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Sonography, Beijing Hospital, National Center of Gerontology, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Beijing, ChinaDepartment of Sonography, Beijing Hospital, National Center of Gerontology, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Beijing, ChinaThe Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, ChinaBackgroundThis study aimed to observe the correlation between renal cortical blood perfusion (CBP) parameters and BP response in patients with severe renal artery stenosis (RAS) who underwent stenting.MethodsThis was a single-center retrospective cohort study. A total of 164 patients with unilateral severe RAS after successful percutaneous transluminal renal artery stenting in Beijing Hospital from October 2017 to December 2020 were included. According to the results of BP evaluated at 12 months, all patients were divided into the BP response group (n = 98) and BP nonresponse group (n = 66). The baseline clinical and imaging characteristics and follow-up data about 24 h ABPM and CBP were recorded and analyzed. Pearson correlation analysis was used to evaluate the relationship between CBP parameters and 24 h average SBP. Univariate and multivariate logistic regression analysis was used to evaluate the risk factors for BP response.ResultsAmong 164 patients with severe RAS, there were 100 males (61.0%), aged 37–75 years, with an average of 56.8 ± 18.4 years, and average artery stenosis of 84.0 ± 12.5%. The BP nonresponse patients had a longer duration of hypertension, more current smoking subjects and diabetic patients, lower eGFR, increased number of hypertensive agents, and rate of insulin compared with the BP response group (P < 0.05). After PTRAS, patients in the BP response group were associated with significantly lower BP and improved CPB, characterized by increased levels of maximum intensity (IMAX), area under ascending curve (AUC1), area under the descending curve (AUC2), shortened rising time (RT), mean transit time (mTT), and prolonged time to peak intensity (TTP; P < 0.05). However, the BP nonresponse group was only associated with significantly reduced RT (P < 0.05) compared with baseline data. During an average follow-up of 11.5 ± 1.7 months, the BP response group was associated with significantly lower levels of SBP, DBP, 24 h average SBP, and 24 h average DBP compared with the nonresponse group (P < 0.05). Pearson correlation analysis showed that the the pre-operative CBP parameters, including IMAX (r = 0.317), RT (r = 0.249), AUC1 (r = 0.614), AUC2 (r = 0.558), and postoperative CBP parameters, including RT (r = 0.283), AUC1 (r = 0.659), and AUC2 (r = 0.674) were significantly positively correlated with the 24 h average SBP, while the postoperative TTP (r = −0.413) and mTT (r = −0.472) were negatively correlated with 24 h average SBP (P < 0.05). Multivariate Logistic regression analysis found that diabetes (OR = 1.294), NT-proBNP (OR = 1.395), number of antihypertensive agents (OR = 2.135), pre-operation IMAX (OR = 1.534), post-operation AUC2 (OR = 2.417), and baseline dDBP (OR = 2.038) were related factors for BP response (all P < 0.05).ConclusionPatients in the BP nonresponse group often have diabetes, a longer duration of hypertension, significantly reduced glomerular filtration rate, and heavier renal artery stenosis. CBP parameters are closely related to 24 h average SBP, and pre-operation IMAX and post-operation AUC2 are markers for a positive BP response.https://www.frontiersin.org/articles/10.3389/fcvm.2022.939519/fullrenal artery stenosis24 h ambulatory blood pressure monitorcontrast-enhanced ultrasoundrenal cortical blood perfusionfollow-up |
| spellingShingle | Siyu Wang Siyu Wang Sijie Zhang Sijie Zhang Sijie Zhang Yan Li Yan Li Na Ma Na Ma Mengpu Li Mengpu Li Hu Ai Hu Ai Hui Zhu Hui Zhu Junhong Ren Junhong Ren Yongjun Li Yongjun Li Peng Li Correlation of renal cortical blood perfusion and BP response after renal artery stenting Frontiers in Cardiovascular Medicine renal artery stenosis 24 h ambulatory blood pressure monitor contrast-enhanced ultrasound renal cortical blood perfusion follow-up |
| title | Correlation of renal cortical blood perfusion and BP response after renal artery stenting |
| title_full | Correlation of renal cortical blood perfusion and BP response after renal artery stenting |
| title_fullStr | Correlation of renal cortical blood perfusion and BP response after renal artery stenting |
| title_full_unstemmed | Correlation of renal cortical blood perfusion and BP response after renal artery stenting |
| title_short | Correlation of renal cortical blood perfusion and BP response after renal artery stenting |
| title_sort | correlation of renal cortical blood perfusion and bp response after renal artery stenting |
| topic | renal artery stenosis 24 h ambulatory blood pressure monitor contrast-enhanced ultrasound renal cortical blood perfusion follow-up |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.939519/full |
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