Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study
Background: Previous data are controversial about the association of renal artery stenosis (RAS) with clinical outcome in patients with heart failure. Definition of RAS in previous studies might not be appropriate. By definition of RAS with renal duplex sonography, we investigated the association of...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2015-01-01
|
| Series: | Chinese Medical Journal |
| Subjects: | |
| Online Access: | http://www.cmj.org/article.asp?issn=0366-6999;year=2015;volume=128;issue=20;spage=2777;epage=2782;aulast=Zheng |
| _version_ | 1811195577678954496 |
|---|---|
| author | Bin Zheng Qin Ma Li-Hong Zheng Qiang Yong Yi-Hua He Jing-Hua Liu |
| author_facet | Bin Zheng Qin Ma Li-Hong Zheng Qiang Yong Yi-Hua He Jing-Hua Liu |
| author_sort | Bin Zheng |
| collection | DOAJ |
| description | Background: Previous data are controversial about the association of renal artery stenosis (RAS) with clinical outcome in patients with heart failure. Definition of RAS in previous studies might not be appropriate. By definition of RAS with renal duplex sonography, we investigated the association of RAS with clinical outcome in patients with heart failure.
Methods: In this retrospective study, we identified 164 patients with heart failure (New York Heart Association classification ≥II; left ventricular ejection fraction <50%) who had received renal duplex sonography during hospital stay. RAS was defined as renal-aortic ratio ≥3.5 or a peak systolic velocity ≥200 cm/s (or both), or occlusion of the renal artery. Categorical data of patients were compared using the Chi-square test or Fisher′s exact test. Cox proportional hazards regression modeling technique was used to investigate the prognostic significance of possible predictors.
Results: Finally, 143 patients were enrolled. Median follow-up time was 32 months (1-53 months). Twenty-two patients were diagnosed as RAS by renal duplex sonography, including 13 unilateral RAS (3 left RAS, 10 right RAS) and 9 bilateral RAS. There were more all-cause mortality and cardiovascular death in patients with RAS than patients without RAS. By multivariate analysis, RAS was a significant predictor for all-cause death and cardiovascular death (hazard ratio [HR] = 4.155, 95% confidence interval [CI]: 1.546-11.164, P = 0.005; and HR = 3.483, 95% CI: 1.200-10.104, P = 0.022, respectively). As for composite endpoint events, including death, nonfatal myocardial infarction, ischemic stroke or intracranial hemorrhage, rehospitalization for cardiac failure, and renal replacement therapy, only angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker was significant predictor. RAS was not a significant predictor for composite endpoint events.
Conclusions: Our data suggested that RAS is associated with a poorer clinical outcome in patients with heart failure. |
| first_indexed | 2024-04-12T00:45:31Z |
| format | Article |
| id | doaj.art-e96c229fa2ad45dca2aefc71dc140860 |
| institution | Directory Open Access Journal |
| issn | 0366-6999 |
| language | English |
| last_indexed | 2024-04-12T00:45:31Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Chinese Medical Journal |
| spelling | doaj.art-e96c229fa2ad45dca2aefc71dc1408602022-12-22T03:54:54ZengWolters KluwerChinese Medical Journal0366-69992015-01-01128202777278210.4103/0366-6999.167353Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF StudyBin ZhengQin MaLi-Hong ZhengQiang YongYi-Hua HeJing-Hua LiuBackground: Previous data are controversial about the association of renal artery stenosis (RAS) with clinical outcome in patients with heart failure. Definition of RAS in previous studies might not be appropriate. By definition of RAS with renal duplex sonography, we investigated the association of RAS with clinical outcome in patients with heart failure. Methods: In this retrospective study, we identified 164 patients with heart failure (New York Heart Association classification ≥II; left ventricular ejection fraction <50%) who had received renal duplex sonography during hospital stay. RAS was defined as renal-aortic ratio ≥3.5 or a peak systolic velocity ≥200 cm/s (or both), or occlusion of the renal artery. Categorical data of patients were compared using the Chi-square test or Fisher′s exact test. Cox proportional hazards regression modeling technique was used to investigate the prognostic significance of possible predictors. Results: Finally, 143 patients were enrolled. Median follow-up time was 32 months (1-53 months). Twenty-two patients were diagnosed as RAS by renal duplex sonography, including 13 unilateral RAS (3 left RAS, 10 right RAS) and 9 bilateral RAS. There were more all-cause mortality and cardiovascular death in patients with RAS than patients without RAS. By multivariate analysis, RAS was a significant predictor for all-cause death and cardiovascular death (hazard ratio [HR] = 4.155, 95% confidence interval [CI]: 1.546-11.164, P = 0.005; and HR = 3.483, 95% CI: 1.200-10.104, P = 0.022, respectively). As for composite endpoint events, including death, nonfatal myocardial infarction, ischemic stroke or intracranial hemorrhage, rehospitalization for cardiac failure, and renal replacement therapy, only angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker was significant predictor. RAS was not a significant predictor for composite endpoint events. Conclusions: Our data suggested that RAS is associated with a poorer clinical outcome in patients with heart failure.http://www.cmj.org/article.asp?issn=0366-6999;year=2015;volume=128;issue=20;spage=2777;epage=2782;aulast=ZhengAtherosclerosis; Cardiac Dysfunction; Heart Failure; Renal Artery Stenosis |
| spellingShingle | Bin Zheng Qin Ma Li-Hong Zheng Qiang Yong Yi-Hua He Jing-Hua Liu Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study Chinese Medical Journal Atherosclerosis; Cardiac Dysfunction; Heart Failure; Renal Artery Stenosis |
| title | Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study |
| title_full | Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study |
| title_fullStr | Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study |
| title_full_unstemmed | Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study |
| title_short | Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study |
| title_sort | analysis of renal artery stenosis in patients with heart failure a rashef study |
| topic | Atherosclerosis; Cardiac Dysfunction; Heart Failure; Renal Artery Stenosis |
| url | http://www.cmj.org/article.asp?issn=0366-6999;year=2015;volume=128;issue=20;spage=2777;epage=2782;aulast=Zheng |
| work_keys_str_mv | AT binzheng analysisofrenalarterystenosisinpatientswithheartfailurearashefstudy AT qinma analysisofrenalarterystenosisinpatientswithheartfailurearashefstudy AT lihongzheng analysisofrenalarterystenosisinpatientswithheartfailurearashefstudy AT qiangyong analysisofrenalarterystenosisinpatientswithheartfailurearashefstudy AT yihuahe analysisofrenalarterystenosisinpatientswithheartfailurearashefstudy AT jinghualiu analysisofrenalarterystenosisinpatientswithheartfailurearashefstudy |